Organization
LASTING IMPRESSION THERAPEUTIC COUNSELING CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIA BUTLER CART, DS (FOUNDER/CEO)
(337) 377-8225
Entity
Organization
Contact information
Practice address
2805 5TH AVE, LAKE CHARLES, LA 70601-7913
(337) 429-5672
(337) 429-5657
Mailing address
2805 5TH AVE, LAKE CHARLES, LA 70601-7913
(337) 377-8225
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2203783804
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2203783804
—
LA
Enumeration date
05/30/2014
Last updated
03/22/2018
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