| Beacon Healing & Wellness LLC | |
|
671 River Highlands Blvd Ste 8 Covington LA 70433-8987 | |
| (985) 624-2942 | |
| (985) 231-1373 |
| Full Name | Beacon Healing & Wellness LLC |
|---|---|
| Speciality | Counselor |
| Location | 671 River Highlands Blvd Ste 8, Covington, Louisiana |
| Authorized Official Name and Position | Phillip Sean Wendell (CEO) |
| Authorized Official Contact | 2258104040 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beacon Healing & Wellness LLC 14707 Perkins Rd Baton Rouge LA 70810-2216 Ph: (225) 810-4040 | Beacon Healing & Wellness LLC 671 River Highlands Blvd Ste 8 Covington LA 70433-8987 Ph: (985) 624-2942 |
| NPI Number | 1457934903 |
|---|---|
| Provider Enumeration Date | 05/03/2021 |
| Last Update Date | 11/13/2023 |
| Certification Date | 11/13/2023 |
| Medicare PECOS PAC ID | 7618371428 |
|---|---|
| Medicare Enrollment ID | O20210802000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457934903 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 1041C0700X | Social Worker - Clinical | () | Secondary |
| 106H00000X | Marriage & Family Therapist | () | Secondary |
| Provider Name | Robert Dahmes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992767537 PECOS PAC ID: 9133396559 Enrollment ID: I20120125000339 |
| Provider Name | Leah P Steele |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053327452 PECOS PAC ID: 1759609449 Enrollment ID: I20150408002717 |
| Provider Name | Tina D Malonson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902437270 PECOS PAC ID: 2961801295 Enrollment ID: I20210519000203 |
| Provider Name | Jena Zanco |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336864461 PECOS PAC ID: 0143687764 Enrollment ID: I20230613000623 |
| Provider Name | Kattie Staudermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558955120 PECOS PAC ID: 1759741176 Enrollment ID: I20230718000259 |
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