Organization
MBRACE WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARGARET MICHELLE BRACE MCKELLAR LPC-S (OWNER)
(318) 470-4315
Entity
Organization
Contact information
Practice address
2924 KNIGHT STREET, SUITE 412, SHREVEPORT, LA 71105-2413
(318) 200-0713
Mailing address
5735 DIXIE SHREVEPORT RD, SHREVEPORT, LA 71107-8991
(318) 470-4315
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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