# THERAPEUTIC MEDICAL & PSYCHIATRIC SERVICES LLC.

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

## Provider details

- **NPI number:** 1750672390
- **Authorized official:** MRS. DIANE PRIVITOR PRIVITOR DAVIS APRN, FNP-C, PMHNPBC (OWNER)
- **Authorized official phone:** (318) 816-5116

## Contact information

- **Practice address:** 1501 STUBBS AVE, MONROE, LA 71292-1106
- **Practice address phone:** (318) 396-9712
- **Practice address fax:** (180) 051-8423
- **Mailing address:** 200 WINTERPARK DR, WEST MONROE, LA 71292-1106
- **Mailing address phone:** (318) 396-9712
- **Mailing address fax:** (180) 051-8423

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LF0000X | Family Nurse Practitioner | APO5002 | LA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/01/2011
- **Last updated:** 12/03/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0000000000000 | PRIVATE INSURANCE | LA |