LADETRICK PROVO (NPI# 1184155731) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184155731 |
| Entity Type | Individual |
| Full Name | LADETRICK PROVO |
| Practice Address |
5476 Summer Dr Baton Rouge LA 70812-3046 |
| Practice Telephone | 2253337899 |
| Mailing Telephone | 2253337899 |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2017-03-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101Y00000X | Counselor | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 000000 | 05 |
| Street Address |
5476 SUMMER DR |
| City | BATON ROUGE |
| State | LA |
| Zip Code | 70812-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205335098 | Oneil Curtis | Non-emergency Medical Transport (VAN) | 8153 Quad Square, Baton Rouge, LA 70812 | 2018-02-07 |
| 1235587635 | Chloie Wallace | Case Manager/Care Coordinator | 5846 Hartford Ave, Baton Rouge, LA 70812 | 2016-05-26 |
| 1134575673 | Tonya Wilson | Non-emergency Medical Transport (VAN) | 5946 Wright Dr, Baton Rouge, LA 70812 | 2016-05-13 |
| 1730558107 | Lagarde's Medical Transportation LLC | Non-emergency Medical Transport (VAN) | 6215 Crestway Ave, Baton Rouge, LA 70812 | 2015-09-16 |
| 1215226956 | Zz and I LLC | Non-emergency Medical Transport (VAN) | 9163 Cedar Ct, Baton Rouge, LA 70812 | 2011-04-04 |
| 1609038850 | Mccorkle Sunrise PCa/sil,llc | Chore Provider | 7262 Poinsettia Drive, Baton Rouge, LA 70812 | 2008-06-30 |
| 1164691259 | Little Ones and Tender Hearts, LLC | Non-emergency Medical Transport (VAN) | 7143 Pitcairn, Baton Rouge, LA 70812 | 2008-02-22 |
| 1770709347 | Health Care Centers In Schools | Clinic/Center | 6650 Cedar Grove Dr, Baton Rouge, LA 70812 | 2007-04-18 |
| 1558388470 | Bethesda Rehabilitation Hospital, Inc. | Rehabilitation Hospital | 7414 Sumrall Drive, Baton Rouge, LA 70812 | 2006-07-16 |
| 1225599152 | Ronald Ben | Case Manager/Care Coordinator | 6968 E Monarch Ave, Baton Rouge, LA 70812-1026 | 2019-03-25 |
| Find all providers in zip 70812 | ||||
| Taxonomy Code | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840444 | Bradford J Williams | Counselor | 624 S 16th St, Baton Rouge, LA 70802-4011 | 2020-10-28 |
| 1255947883 | Vanessa Brown | Counselor | 12438 Lockhaven Ave, Baton Rouge, LA 70815-6537 | 2020-09-18 |
| 1588287809 | Catherine Vicknair | Counselor | 8755 Sullivan Rd Ste 3a, Baton Rouge, LA 70818-6031 | 2020-05-20 |
| 1174144596 | Feleshia N Borskey Young | Counselor | 3940 Prescott Rd Ste A, Baton Rouge, LA 70805-5143 | 2020-04-27 |
| 1396208617 | Trinette Amelia Jackson | Counselor | 4336 North Blvd Ste 104, Baton Rouge, LA 70806-3920 | 2019-04-12 |
| 1639632169 | Ezekiel Alsander | Counselor | 6929 Commerce Cir Apt 6101, Baton Rouge, LA 70809-1887 | 2019-04-11 |
| 1366903908 | Tamika Wyna Piper | Counselor | 11445 Reiger Road, Baton Rouge, LA 70809 | 2019-03-27 |
| 1386101764 | Joseph Stevenson | Counselor | 6245 Cedar Grove Dr, Baton Rouge, LA 70812-1730 | 2019-02-21 |
| 1891252276 | Laketa Smith | Counselor | 8365 Siegen Ln Apt 4, Baton Rouge, LA 70810-1901 | 2019-02-21 |
| 1083170500 | Lashona Latrice Alexander | Counselor | 4845 Jamestown Ave Ste 208, Baton Rouge, LA 70808-3248 | 2019-02-20 |
| Find all providers in BATON ROUGE | ||||
| City | BATON ROUGE |
| Zip Code | 70812 |
Please comment or provide details below to improve the information on LADETRICK PROVO.
| 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.