Eclectic Cognitive Behavioral Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

3676 Issued in LA

Legal business name

ECLECTIC COGNITIVE BEHAVIORAL CENTER, LLC

Practice address

1733 Wooddale Blvd
Baton Rouge, LA 70806-1508

Phone

(225) 924-2800

Fax

(225) 924-2800

NPI assigned

Mar 31, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Jacqueline M Mims, EDD, PHDNPI 1639317878

Title

Clinical Director/Ceo

Phone

(225) 924-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Mims, LPC

  • Mental Health Counselor
  • Baton Rouge, LA
  • NPI 1639317878
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1396224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438992000000",
    "number": "1063830727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 WOODDALE BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061508",
            "telephone_number": "225-924-2800",
            "fax_number": "225-924-2800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 WOODDALE BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708061508",
            "telephone_number": "225-924-2800",
            "fax_number": "225-924-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ECLECTIC COGNITIVE BEHAVIORAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-31",
        "last_updated": "2015-08-08",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/CEO",
        "authorized_official_telephone_number": "225-924-2800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "EDD, PHD"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "3676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600559886",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gift Echefu, MD
• Michael B Echols, CIT
• Elizabeth Juliann Eckelmann
• Bryan Campbell Eckert, PSY.D.
• Tara Eckles
• Eclipse Wellness and Performance Center, LLC
• Eco Behavioral Health Coalition
• Ed Bateman DDS a Professional Dental Corporation
• Eddie St-Vil Counseling & Consulting
• Brittany Alon Eddie

• Community/Behavioral Health Agency in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Community/Behavioral Health Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.