Organization
BRIGHT CLINIC
Active
Other names
Brightside Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
EVON ROQUEMORE (CEO)
(888) 417-5250
Entity
Organization
Contact information
Practice address
106 BUSINESS PARK AVENUE, DENHAM SPRINGS, LA 70726
(225) 921-5392
Mailing address
106 BUSINESS PARK AVENUE, DENHAM SPRINGS, LA 70726
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
2084P0800X
Psychiatry Physician
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
07/08/2021
Last updated
03/19/2024
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