NPIMap

Organization Active NPI

Tele Med Clinix Lousiana

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Monroe, LA
National Provider Identifier
1346085719
Registry record updated Jun 27, 2024
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
TELE MED CLINIX LOUSIANA
Practice address
215 Northpark Dr
Monroe, LA 71203-6520
Phone
(321) 209-4040
Fax
(321) 999-9240
NPI assigned
Jun 27, 2024
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Andrew Brown
Title
Ceo
Phone
(321) 209-4040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

215 Northpark Dr
Monroe, LA 71203-6520

Mailing address

570 Lexington Green LN
Sanford, FL 32771-1026
Phone (321) 209-4040

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1719446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1346085719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 LEXINGTON GREEN LN",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327711026",
            "telephone_number": "321-209-4040",
            "fax_number": "321-999-9240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 NORTHPARK DR",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712036520",
            "telephone_number": "321-209-4040",
            "fax_number": "321-999-9240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TELE MED CLINIX LOUSIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-27",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "321-209-4040"
    },
    "taxonomies": [
        {
            "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 Monroe, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.