| Counseling Services Of Southwest Louisiana, Inc. | |
|
133 Jefferson Dr Lake Charles LA 70605-5713 | |
| (337) 431-7194 | |
| (337) 431-7198 |
| Full Name | Counseling Services Of Southwest Louisiana, Inc. |
|---|---|
| Speciality | Counselor |
| Location | 133 Jefferson Dr, Lake Charles, Louisiana |
| Authorized Official Name and Position | Randy North (CEO) |
| Authorized Official Contact | 3374317194 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Counseling Services Of Southwest Louisiana, Inc. 133 Jefferson Dr Lake Charles LA 70605-5713 Ph: (337) 431-7194 | Counseling Services Of Southwest Louisiana, Inc. 133 Jefferson Dr Lake Charles LA 70605-5713 Ph: (337) 431-7194 |
| NPI Number | 1831244821 |
|---|---|
| Provider Enumeration Date | 01/23/2007 |
| Last Update Date | 06/08/2023 |
| Certification Date | 06/08/2023 |
| Medicare PECOS PAC ID | 4981931201 |
|---|---|
| Medicare Enrollment ID | O20190809000571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831244821 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Sandra Isabel Viggiani |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467768788 PECOS PAC ID: 4486981719 Enrollment ID: I20190809000827 |
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