Organization
MIND, BODY & SOUL OF NEW ORLEANS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALBERT BRYAN LAC (CEO)
(504) 331-5788
Entity
Organization
Contact information
Practice address
57 5TH ST, GRETNA, LA 70053-4744
(504) 331-5788
Mailing address
57 5TH ST, GRETNA, LA 70053-4744
(504) 331-5788
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
1167
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
1167
LA
101YM0800X
Mental Health Counselor
1167
LA
101YS0200X
School Counselor
1167
LA
104100000X
Social Worker
1167
LA
1041C0700X
Clinical Social Worker
1167
LA
Other
Enumeration date
07/03/2008
Last updated
07/03/2008
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