| Family Therapy Clinic Of Louisiana, Llc | |
|
7738 Don Budge Ave Baton Rouge LA 70810-1710 | |
| (225) 292-0155 | |
| (844) 715-7911 |
| Full Name | Family Therapy Clinic Of Louisiana, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7738 Don Budge Ave, Baton Rouge, Louisiana |
| Authorized Official Name and Position | Erich G Duchmann (OWNER/MANAGER) |
| Authorized Official Contact | 2252920155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Therapy Clinic Of Louisiana, Llc Po Box 83980 Baton Rouge LA 70884-3980 Ph: (225) 292-0155 | Family Therapy Clinic Of Louisiana, Llc 7738 Don Budge Ave Baton Rouge LA 70810-1710 Ph: (225) 292-0155 |
| NPI Number | 1629018585 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 10/20/2021 |
| Certification Date | 10/20/2021 |
| Medicare PECOS PAC ID | 1658383492 |
|---|---|
| Medicare Enrollment ID | O20101109000265 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629018585 | NPI | - | NPPES |
| Provider Name | Brenda L Durbin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821059155 PECOS PAC ID: 0648289728 Enrollment ID: I20060418000581 |
| Provider Name | Erich G Duchmann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629039987 PECOS PAC ID: 4486668118 Enrollment ID: I20060627000215 |
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