| Acadiana Medical Psychological Services, Llc | |
|
93 Magnate Dr Lafayette LA 70508-3840 | |
| (337) 889-5830 | |
| (337) 889-5834 |
| Full Name | Acadiana Medical Psychological Services, Llc |
|---|---|
| Speciality | Psychologist |
| Location | 93 Magnate Dr, Lafayette, Louisiana |
| Authorized Official Name and Position | Christopher Scott Eckholdt (OWNER) |
| Authorized Official Contact | 3378895830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Acadiana Medical Psychological Services, Llc 93 Magnate Dr Lafayette LA 70508-3840 Ph: (337) 889-5830 | Acadiana Medical Psychological Services, Llc 93 Magnate Dr Lafayette LA 70508-3840 Ph: (337) 889-5830 |
| NPI Number | 1598126351 |
|---|---|
| Provider Enumeration Date | 03/08/2016 |
| Last Update Date | 05/19/2016 |
| Medicare PECOS PAC ID | 7416247119 |
|---|---|
| Medicare Enrollment ID | O20160608002473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598126351 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | John M Tracy |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437650330 PECOS PAC ID: 1355606336 Enrollment ID: I20180522000441 |
| Provider Name | Cedrina K Averette |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124520309 PECOS PAC ID: 6103181102 Enrollment ID: I20180522001377 |
| Provider Name | Glynis V Rennels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538725510 PECOS PAC ID: 9335471911 Enrollment ID: I20191031001227 |
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