# JENNINGS BEHAVIORAL HEALTH, LLC

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

## Provider details

- **NPI number:** 1891947479
- **Authorized official:** MRS. STACY GAUDET (MGR SULPHUR OUTPATIENT CLINIC)
- **Authorized official phone:** (337) 527-7878

## Contact information

- **Practice address:** 110 E DARBONNE ST, SULPHUR, LA 70663-4958
- **Practice address phone:** (337) 527-7878
- **Practice address fax:** (337) 527-7880
- **Mailing address:** 110 E DARBONNE ST, SULPHUR, LA 70663-4958
- **Mailing address phone:** (337) 527-7878
- **Mailing address fax:** (337) 527-7880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | 1055 | LA | — |
| 1041C0700X | Clinical Social Worker | 8971 | LA | — |
| 2084P0800X | Psychiatry Physician | 021615 | LA | — |
| 208D00000X | General Practice Physician | 014484R | LA | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AP 05359 | LA | Yes |

## Other

- **Enumeration date:** 10/15/2008
- **Last updated:** 10/15/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1949744 | — | LA |
| 01 | — | 5C425 | MEDICARE | LA |