| Mmt Therapy And Wellness | |
|
814 Fortune Rd Ste 108 Youngsville LA 70592-5542 | |
| (337) 513-0822 | |
| (337) 202-2376 |
| Full Name | Mmt Therapy And Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 814 Fortune Rd Ste 108, Youngsville, Louisiana |
| Authorized Official Name and Position | Michele Thibodeaux (LCSW) |
| Authorized Official Contact | 3375018697 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mmt Therapy And Wellness 8448 Steve Rd Kaplan LA 70548-6437 Ph: () - | Mmt Therapy And Wellness 814 Fortune Rd Ste 108 Youngsville LA 70592-5542 Ph: (337) 513-0822 |
| NPI Number | 1841985173 |
|---|---|
| Provider Enumeration Date | 04/11/2023 |
| Last Update Date | 09/27/2023 |
| Certification Date | 09/27/2023 |
| Medicare PECOS PAC ID | 8426403346 |
|---|---|
| Medicare Enrollment ID | O20231012003423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841985173 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Michele M Thibodeaux |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992443469 PECOS PAC ID: 9335594258 Enrollment ID: I20231012003513 |
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