Organization
DEPARTMENT OF HEALTH AND HOSPITALS
Active
Other names
Behavioral Health Clinic of Central La (AD)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN EGAN JONES LCSW (REGIONAL ADMINISTRATOR)
(318) 487-5191
Entity
Organization
Contact information
Practice address
242 WEST SHAMROCK, UNIT 1, PINEVILLE, LA 71360
(318) 488-6846
(318) 488-6844
Mailing address
PO BOX 7473, ALEXANDRIA, LA 71306-7473
(318) 488-6846
(318) 488-6844
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CAC #1330
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC # 904
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC #713
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC 592
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
RAC #1340
LA
1041C0700X
Clinical Social Worker
LMSW #4870
LA
1041C0700X
Clinical Social Worker
RSW # 7478
LA
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
RN #055444
LA
164W00000X
Licensed Practical Nurse
LPN # 850513
LA
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
MD 017125
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9759
BLUECROSS BLUESHILED
LA
Enumeration date
04/17/2006
Last updated
07/28/2011
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