| Brighthope Counseling, Llc | |
|
701 S Royal St Deridder LA 70634-4949 | |
| (337) 463-4900 | |
| (337) 463-4908 |
| Full Name | Brighthope Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 S Royal St, Deridder, Louisiana |
| Authorized Official Name and Position | Mark David Ifland (OWNER) |
| Authorized Official Contact | 3374634900 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brighthope Counseling, Llc Po Box 1022 Deridder LA 70634-1022 Ph: () - | Brighthope Counseling, Llc 701 S Royal St Deridder LA 70634-4949 Ph: (337) 463-4900 |
| NPI Number | 1386352268 |
|---|---|
| Provider Enumeration Date | 11/09/2022 |
| Last Update Date | 11/09/2022 |
| Certification Date | 11/09/2022 |
| Medicare PECOS PAC ID | 8628412905 |
|---|---|
| Medicare Enrollment ID | O20240214001980 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386352268 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Mark David Ifland |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538268149 PECOS PAC ID: 9638521891 Enrollment ID: I20240214002067 |
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