| Adjuvant Behavioral Health Of Louisiana, Llc | |
|
333 Texas St Ste 1300 1368 Shreveport LA 71101-3666 | |
| (866) 912-2746 | |
| (800) 420-2305 |
| Full Name | Adjuvant Behavioral Health Of Louisiana, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 333 Texas St Ste 1300 1368, Shreveport, Louisiana |
| Authorized Official Name and Position | Joshua Myers (CEO) |
| Authorized Official Contact | 8669122746 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adjuvant Behavioral Health Of Louisiana, Llc 11754 Jollyville Rd Ste 110 Austin TX 78759-3948 Ph: (866) 912-2746 | Adjuvant Behavioral Health Of Louisiana, Llc 333 Texas St Ste 1300 1368 Shreveport LA 71101-3666 Ph: (866) 912-2746 |
| NPI Number | 1568204253 |
|---|---|
| Provider Enumeration Date | 06/12/2024 |
| Last Update Date | 11/11/2024 |
| Certification Date | 11/11/2024 |
| Medicare PECOS PAC ID | 8729518451 |
|---|---|
| Medicare Enrollment ID | O20250211002801 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568204253 | NPI | - | NPPES |
| Provider Name | Lynley Katherine Dornier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205450871 PECOS PAC ID: 8729401161 Enrollment ID: I20200702000354 |
| Provider Name | Amy Root |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528577707 PECOS PAC ID: 4981960473 Enrollment ID: I20250320003753 |
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