Active NPI
Supportive Care of Louisiana LLC
- Clinical Psychologist
- Baton Rouge, LA
National Provider Identifier
1619611381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- Legal business name
- SUPPORTIVE CARE OF LOUISIANA LLC
- Practice address
- 3867 Plaza Tower Dr FL 1
Baton Rouge, LA 70816-4378 - Phone
- (718) 298-4375
- NPI assigned
- Apr 27, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Raphael Lichtschein
- Title
- President
- Phone
- (718) 298-4375
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | Primary | ||
| Clinical Social Worker | 1041C0700X | |||
| Psychiatry Physician | 2084P0800X |
Addresses
Primary practice location
3867 Plaza Tower Dr FL 1
Baton Rouge, LA 70816-4378
Mailing address
27 Randolph Rd
Howell, NJ 07731-8611
Phone (718) 298-4372
National Provider Directory
National Provider DirectoryLocations
27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651017600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1651017600000",
"number": "1619611381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "27 RANDOLPH RD",
"city": "HOWELL",
"state": "NJ",
"postal_code": "077318611",
"telephone_number": "718-298-4372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3867 PLAZA TOWER DR FL 1",
"city": "BATON ROUGE",
"state": "LA",
"postal_code": "708164378",
"telephone_number": "718-298-4375"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUPPORTIVE CARE OF LOUISIANA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2022-04-27",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A",
"authorized_official_last_name": "LICHTSCHEIN",
"authorized_official_first_name": "RAPHAEL",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "718-298-4375"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychologist, Clinical",
"state": null,
"license": null,
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baton Rouge, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.