Organization
LASTING IMPRESSION THERAPEUTIC COUNSELING CENTER, LLC
Active
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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