Beacon Behavioral Outpatient - Bogalusa LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BEACON BEHAVIORAL OUTPATIENT - BOGALUSA LLC

Practice address

1640 S Columbia St
Bogalusa, LA 70427-5800

Phone

(985) 735-1750

NPI assigned

Apr 24, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Phillip Sean Wendell

Title

Ceo

Phone

(225) 252-4758

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1745452800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1659168490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14707 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708102216",
            "telephone_number": "504-910-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 S COLUMBIA ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704275800",
            "telephone_number": "985-735-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON BEHAVIORAL OUTPATIENT - BOGALUSA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-24",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "WENDELL",
        "authorized_official_first_name": "PHILLIP",
        "authorized_official_middle_name": "SEAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "225-252-4758",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Bradford Bardy, P.T., D.P.T.
• Shannon H Barnes
• Kenberly Kay Baughman, MSN, APRN, FNP-C
• Billy Kevin Beach, PTA
• Beacon Behavioral Hospital Northshore, LLC
• Tammy Roxanne Bennett, RN
• Maria Delpilar Bernal, M.D.
• Joseph Ellis Bernard III, D.D.S.
• Devendra Bhandari, M.D.
• BHG Lxii LLC

• Community/Behavioral Health Agency in Bogalusa, LA
• Providers in Bogalusa, LA by specialty
• Community/Behavioral Health Agency in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.