# LOUISIANA MIND BODY & HEALTH LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700602398
- **Authorized official:** CRYSTAL THOMAS (PRESIDENT)
- **Authorized official phone:** (318) 216-1010

## Contact information

- **Practice address:** 5416 HIGHWAY 28 E, PINEVILLE, LA 71360-4756
- **Practice address phone:** (318) 216-1010
- **Practice address fax:** (318) 302-0504
- **Mailing address:** 5416 HIGHWAY 28 E, PINEVILLE, LA 71360-4756
- **Mailing address phone:** (318) 216-1010
- **Mailing address fax:** (318) 302-0504

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103TH0100X | Health Service Psychologist | — | NULL | — |
| 103TH0100X | Health Service Psychologist | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 11/27/2024
- **Last updated:** 03/31/2025