LEGACY BEHAVIORAL HEALTH (NPI# 1104169382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104169382 |
| Entity Type | Organization |
| Organization Name | LEGACY BEHAVIORAL HEALTH |
| Practice Address |
7290 Siegen Lane Baton Rouge LA 70810 |
| Practice Telephone | 2258193262 |
| Mailing Telephone | 2258193262 |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |
| Authorized Official Name | LYDIA YOUNG (OWNER) |
| Authorized Official Telephone | 2258193262 |
| Authorized Official Credential | NP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
7290 SIEGEN LANE |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639734973 | Baton Rouge Clinic, A Medical Corporation | Podiatrist | 8160 Ymca Blvd, Suite C, Baton Rouge, LA 70810 | 2019-05-02 |
| 1699278135 | Taylor Denise Debourg | Specialist/Technologist | 8921 Boone Drive, Baton Rouge, LA 70810 | 2018-03-12 |
| 1528583945 | Baton Rouge Perio, L.L.C. | Dentist | 10723 N. Oak Hills Parkway, Bldg. B, Baton Rouge, LA 70810 | 2017-08-07 |
| 1902334931 | Reginald Shaffer | Counselor | 13621 Kenner Ave Apt C, Baton Rouge, LA 70810 | 2017-06-03 |
| 1770010381 | Keona Julien | Case Manager/Care Coordinator | 9270 Siegen Ln Suite 101, Baton Rouge, LA 70810 | 2017-05-12 |
| 1205372893 | Grand Canyon Mobile Dentistry | Dentist | 8480 Bluebonnet Blvd Ste E, Baton Rouge, LA 70810 | 2017-01-06 |
| 1215395173 | Kimberly Booker | Counselor | 9371 Bimini Dr, Baton Rouge, LA 70810 | 2016-02-08 |
| 1710354022 | St Gabriel Health Clinic, Inc | Clinic/Center | 9211 Parkway Dr, Baton Rouge, LA 70810 | 2015-08-24 |
| 1942682430 | Jasmine Alexander | Counselor | 9270 Siegen Ln Bldg 101, Baton Rouge, LA 70810 | 2015-06-22 |
| 1073991535 | James Michael Robinson | Family Medicine | 12525 Perkins Rd Ste A, Baton Rouge, LA 70810 | 2015-05-15 |
| Find all providers in zip 70810 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835346 | Cassandra Thomas-jingles Psychiatric Nurse Practitioner, LLC. | Nurse Practitioner | 156 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2019-01-26 |
| 1659733236 | Synergy Behavioral Health Services LLC | Nurse Practitioner | 355 Saint Charles St, Baton Rouge, LA 70802-5948 | 2016-03-23 |
| 1841617594 | Amy Lacouture | Nurse Practitioner | 16539 Centurion Ave, Baton Rouge, LA 70816-1924 | 2014-03-19 |
| 1659667301 | Ccp Enterprises, LLC | Nurse Practitioner | 19111 Bellerive Ct, Baton Rouge, LA 70809-6736 | 2011-06-21 |
| 1518278589 | Andrea Delaune Plauche | Nurse Practitioner | 2798 Oneal Ln, Ste. 8, Baton Rouge, LA 70816-3407 | 2010-06-24 |
| 1932317138 | Andre Stewart | Nurse Practitioner | 4040 North Blvd Ste A, Baton Rouge, LA 70806-3829 | 2007-05-19 |
| 1689662439 | Robert Allen Varnado | Nurse Practitioner | 5240 Stonewall Dr, Baton Rouge, LA 70817-2549 | 2005-10-06 |
| 1467445718 | Staci S. Gulino | Nurse Practitioner | 9311a Bluebonnet Blvd, Baton Rouge, LA 70810-2806 | 2005-08-23 |
| 1801495304 | Anita L Gilbert | Nurse Practitioner | 2798 Oneal Ln Ste 8, Baton Rouge, LA 70816-3408 | 2020-10-26 |
| 1710511241 | Crystal Caraccioli Hebert | Nurse Practitioner | 5131 Odonovan Dr Ste 300, Baton Rouge, LA 70808-4792 | 2020-02-24 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70810 |
Please comment or provide details below to improve the information on LEGACY BEHAVIORAL HEALTH.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.