Organization
CHANGING MATTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RACHEL DAVIS LCSW (OWNER / CLINICAL DIRECTOR)
(225) 252-2212
Entity
Organization
Contact information
Practice address
411 E MULBERRY ST, AMITE, LA 70422-2527
(225) 252-2212
(985) 748-8515
Mailing address
PO BOX 476, AMITE, LA 70422-0476
(225) 252-2212
(985) 748-8515
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1009
LA
1041C0700X
Clinical Social Worker
Primary
8468
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600551753
—
LA
Enumeration date
11/14/2013
Last updated
11/30/2013
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