Slidell Counseling, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

4592 Issued in LA

Legal business name

SLIDELL COUNSELING, LLC

Practice address

2800 Gause Blvd E
Suite B
Slidell, LA 70461-4247

Phone

(985) 649-0455

Fax

(985) 649-0455

NPI assigned

Aug 6, 2009

Organization subpart

No

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

Authorized official

Name

Kim Marcus Gordon, LCSW

Title

Owner

Phone

(504) 319-8247

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1249516800000",
    "number": "1316178353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 HERRING DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704611113",
            "telephone_number": "504-319-8247",
            "fax_number": "985-649-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 GAUSE BLVD E",
            "address_2": "SUITE B",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704614247",
            "telephone_number": "985-649-0455",
            "fax_number": "985-649-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLIDELL COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "MARCUS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-319-8247",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "4592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Slidell, LA
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• Community/Behavioral Health Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.