Organization
BEHAVIORAL HEALTH CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW JUSTIN THRASHER III PHD (CLINICAL DIRECTOR)
(337) 625-5766
Entity
Organization
Contact information
Practice address
2500 MAPLEWOOD DR STE 1, SULPHUR, LA 70663-6100
(337) 625-5766
(225) 208-1056
Mailing address
2500 MAPLEWOOD DR STE 1, SULPHUR, LA 70663-6100
(337) 625-5766
(225) 208-1056
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1412
LA
363LP0200X
Pediatric Nurse Practitioner
AP05308
LA
Other
Enumeration date
06/10/2018
Last updated
06/10/2018
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