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Organization

BECERRA WELLNESS LLC

Active
Other names
Becerra Wellness LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL BECERRA (OWNER, DIRECTOR OF COUNSELING LPC-S)
(318) 200-0573
Entity
Organization

Contact information

Practice address
800 SPRING ST STE 202, SHREVEPORT, LA 71101-3757
(318) 200-0573
Mailing address
1519 AUDUBON PL, SHREVEPORT, LA 71105-3417
(469) 545-4611

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
101YP2500X
Professional Counselor
103K00000X
Behavior Analyst
103TA0700X
Adult Development & Aging Psychologist
103TB0200X
Cognitive & Behavioral Psychologist
103TF0000X
Family Psychologist
174H00000X
Health Educator
225C00000X
Rehabilitation Counselor
225CA2400X
Assistive Technology Practitioner Rehabilitation Counselor

Other

Enumeration date
04/01/2024
Last updated
04/01/2024
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