| Waits Psychological Services Llc | |
|
3816 Woodburn St Ruston LA 71270-8520 | |
| (850) 830-2264 | |
| Not Available |
| Full Name | Waits Psychological Services Llc |
|---|---|
| Speciality | Psychologist |
| Location | 3816 Woodburn St, Ruston, Louisiana |
| Authorized Official Name and Position | John B Waits (PROVIDER/PSYCHOLOGIST) |
| Authorized Official Contact | 8508302264 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Waits Psychological Services Llc 3816 Woodburn St Ruston LA 71270-8520 Ph: (850) 830-2264 | Waits Psychological Services Llc 3816 Woodburn St Ruston LA 71270-8520 Ph: (850) 830-2264 |
| NPI Number | 1437744455 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 03/02/2021 |
| Certification Date | 03/02/2021 |
| Medicare PECOS PAC ID | 1951717040 |
|---|---|
| Medicare Enrollment ID | O20210316001144 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437744455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC1900X | Psychologist - Counseling | (* (Not Available)) | Primary |
| Provider Name | John Brandon Waits |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528331154 PECOS PAC ID: 2860808953 Enrollment ID: I20210316001207 |
| Provider Name | Ashley Kober |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1326512765 PECOS PAC ID: 7416309257 Enrollment ID: I20240117003858 |
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