NPIMap

Organization Active NPI

Imperial Calcasieu Human Services Authority

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lake Charles, LA
National Provider Identifier
1457789802
Registry record updated Oct 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
95 Issued in LA
Legal business name
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY
Practice address
3505 5TH Ave
Suite C
Lake Charles, LA 70607-2156
Phone
(337) 475-3100
Fax
(337) 475-3105
NPI assigned
Oct 23, 2013
Organization subpart
Yes
Parent organization
IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 23, 2013

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

Authorized official

Name
Ms. Tanya McGee, LAC
Title
Executive Director
Phone
(337) 475-3100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X 95 LA Primary

Addresses

Primary practice location

3505 5TH Ave
Suite C
Lake Charles, LA 70607-2156

Mailing address

3505 5TH Ave
Suite C
Lake Charles, LA 70607-2156
Phone (337) 475-3100

Other identifiers 1

IdentifierTypeStateIssuer
1710041MedicaidLA

Other names 1

  • LCBHC Childrens Outreach Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Imperial Calcasieu Hsa8 organizations share this tax ID, including this one
Part of
Imperial Calcasieu Hsa

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3505 5th Ave
Ste C
Lake Charles, LA 70607
Phone (337) 475-3100

NPI Registry JSON

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

{
    "created_epoch": "1382486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382486400000",
    "number": "1457789802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 5TH AVE",
            "address_2": "SUITE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706072156",
            "telephone_number": "337-475-3100",
            "fax_number": "337-475-3105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3505 5TH AVE",
            "address_2": "SUITE C",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706072156",
            "telephone_number": "337-475-3100",
            "fax_number": "337-475-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "IMPERIAL CALCASIEU HUMAN SERVICES AUTHORITY",
        "enumeration_date": "2013-10-23",
        "last_updated": "2013-10-23",
        "status": "A",
        "authorized_official_last_name": "MCGEE",
        "authorized_official_first_name": "TANYA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "337-475-3100",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LAC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "95",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710041",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCBHC Childrens Outreach Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 23, 2013; 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.