| At & Tc Consultation Services, Pllc | |
|
4673 Eugene Ware Blvd Bastrop LA 71220-1425 | |
| (318) 281-2448 | |
| (318) 281-5445 |
| Full Name | At & Tc Consultation Services, Pllc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 4673 Eugene Ware Blvd, Bastrop, Louisiana |
| Authorized Official Name and Position | Althea Conley (INCORPORATOR/ORGANIZER) |
| Authorized Official Contact | 3182812448 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| At & Tc Consultation Services, Pllc 410 S Franklin St Bastrop LA 71220-4533 Ph: (318) 281-2448 | At & Tc Consultation Services, Pllc 4673 Eugene Ware Blvd Bastrop LA 71220-1425 Ph: (318) 281-2448 |
| NPI Number | 1699369991 |
|---|---|
| Provider Enumeration Date | 02/26/2021 |
| Last Update Date | 02/26/2021 |
| Certification Date | 02/26/2021 |
| Medicare PECOS PAC ID | 3779991088 |
|---|---|
| Medicare Enrollment ID | O20210426000667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699369991 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Primary |
| Provider Name | Althea T Conley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114995198 PECOS PAC ID: 7517851413 Enrollment ID: I20100727000729 |
| Provider Name | Tiana S Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770879074 PECOS PAC ID: 9032376579 Enrollment ID: I20120210000389 |
| Provider Name | Carleen Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124562871 PECOS PAC ID: 0547545659 Enrollment ID: I20210506002773 |
| Provider Name | Margarette Lenard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922303981 PECOS PAC ID: 1153616958 Enrollment ID: I20210902000630 |
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