NPIMap

Organization Active NPI

Acadian Holistic Services LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Charles, LA
National Provider Identifier
1275240228
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
ACADIAN HOLISTIC SERVICES LLC
Practice address
2829 4TH Ave Ste 215
Lake Charles, LA 70601-7887
Phone
(337) 707-3872
NPI assigned
Oct 31, 2022
Last updated
Jun 5, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Authorized official

Name
Michael JohnsonNPI 1487184347
Title
Program Administrator/Owner
Phone
(337) 707-3872

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X
Community/Behavioral Health Agency 251S00000X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2829 4TH Ave Ste 215
Lake Charles, LA 70601-7887

Mailing address

2829 4TH Ave # 215
Lake Charles, LA 70601-7887
Phone (337) 429-5105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230725001847 LA Part B Supplier - Clinic/Group Practice 0042671950 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Charles, LA

National Provider Directory

National Provider Directory

Locations

2829 4th Ave
#215
Lake Charles, LA 70601
Phone (337) 429-5105

2829 4th Ave
Ste 215
Lake Charles, LA 70601
Phone (337) 707-3872

500 Broad St
#213
Lake Charles, LA 70601
Phone (337) 429-5105

500 Broad St
Ste 213
Lake Charles, LA 70601
Phone (337) 429-5105

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1667174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685923200000",
    "number": "1275240228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2829 4TH AVE # 215",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017887",
            "telephone_number": "337-429-5105",
            "fax_number": "337-888-9853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2829 4TH AVE STE 215",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706017887",
            "telephone_number": "337-707-3872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACADIAN HOLISTIC SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-31",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR/OWNER",
        "authorized_official_telephone_number": "337-707-3872"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.