Organization
MECHELE DE AVILA, LCSW, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MECHELE DE AVILA EVANS LCSW (OWNER)
(504) 453-0216
Entity
Organization
Contact information
Practice address
1082 HAVENWOOD DRIVE, BACK APARTMENT, BATON ROUGE, LA 70815-6730
(225) 366-8606
(225) 410-0080
Mailing address
PO BOX 41001, BATON ROUGE, LA 70835
(225) 366-8606
(225) 410-0080
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
4065
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1549495
—
LA
Enumeration date
05/16/2013
Last updated
07/21/2022
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