Organization
PSYCHOTHERAPY & WELLNESS GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN PAUL HENNICK M.ED. (OWNER/COUNSELOR)
(985) 796-7006
Entity
Organization
Contact information
Practice address
390 VILLAGE FARMS LN, FOLSOM, LA 70437-6118
(985) 796-7006
(985) 235-0086
Mailing address
390 VILLAGE FARMS LN, FOLSOM, LA 70437-6118
(985) 796-7006
(985) 235-0086
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
4920
LA
101YP2500X
Professional Counselor
5023
LA
1041C0700X
Clinical Social Worker
11190
LA
Other
Enumeration date
01/05/2015
Last updated
01/05/2015
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