| Premier Therapeutics, LLC | |
|
827 W 22nd Ave Covington LA 70433-1433 | |
| (985) 377-6983 | |
| Not Available |
| Full Name | Premier Therapeutics, LLC |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 827 W 22nd Ave, Covington, Louisiana |
| Authorized Official Name and Position | Kevin J Brown (OWNER) |
| Authorized Official Contact | 9853776983 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Therapeutics, LLC 222 N Vermont St Ste S Covington LA 70433-3240 Ph: (985) 377-6983 | Premier Therapeutics, LLC 827 W 22nd Ave Covington LA 70433-1433 Ph: (985) 377-6983 |
| NPI Number | 1164912853 |
|---|---|
| Provider Enumeration Date | 05/17/2018 |
| Last Update Date | 01/17/2020 |
| Certification Date | 01/17/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164912853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 225700000X | Massage Therapist | LA-4964 (Louisiana) | Secondary |
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