Active NPI
Instneuropsychadvanced HC
- Community/Behavioral Health Agency
- Lake Charles, LA
National Provider Identifier
1063569648
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- ADC6247
- Legal business name
- INSTNEUROPSYCHADVANCED HC
- Practice address
- 2829 4TH Ave
150
Lake Charles, LA 70601-7887 - Phone
- (337) 477-7091
- Fax
- (337) 474-4552
- NPI assigned
- Jan 4, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dewey D Archer Jr., MD
- Title
- Presidentceo
- Phone
- (337) 477-7091
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | ADC6247 | LA | Primary |
Addresses
Primary practice location
2829 4TH Ave
150
Lake Charles, LA 70601-7887
Mailing address
2829 4TH Ave
150
Lake Charles, LA 70601-7887
Phone (337) 477-7091
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1551228 | Medicaid | LA |
National Provider Directory
National Provider Directory- Tax ID family
- Institute of Neuropsychiatry
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Psychiatric Hospital
- Pearland, TX
- NPI 1164699757
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatry Physician
- Muskogee, OK
- NPI 1063406437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1063569648",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2829 4TH AVE",
"address_2": "150",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706017887",
"telephone_number": "337-477-7091",
"fax_number": "337-474-4552"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2829 4TH AVE",
"address_2": "150",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706017887",
"telephone_number": "337-477-7091",
"fax_number": "337-474-4552"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "INSTNEUROPSYCHADVANCED HC",
"organizational_subpart": "NO",
"enumeration_date": "2007-01-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "ARCHER",
"authorized_official_first_name": "DEWEY",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENTCEO",
"authorized_official_telephone_number": "337-477-7091",
"authorized_official_name_suffix": "Jr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "LA",
"license": "ADC6247",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1551228",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.