Organization
ST JAMES COMMUNITY FRESH START PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTHA MAE DAVIS WILLIAMS PHD NBCC (DIRECTOR CEO)
(225) 623-9751
Entity
Organization
Contact information
Practice address
108 N EZIDORE ST, GRAMERCY, LA 70052-0850
(225) 258-4029
(225) 258-4109
Mailing address
PO BOX 850, GRAMERCY, LA 70052-0850
(225) 258-4029
(225) 258-4109
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
2355S0801X
Speech-Language Assistant
—
—
Other
Enumeration date
05/17/2007
Last updated
07/09/2008
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