Lastachia Henderson
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Farmerville, LA
NPI 1750145546 · NPPES record last updated Feb 12, 2024
Key facts
- NPI
- 1750145546
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- CIT-5671 (LA)
- Practice address
- 511 Sterlington Hwy
Farmerville, LA 71241-3122 - Phone
- (318) 309-1449
- NPI assigned
- Feb 12, 2024
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CIT-5671 | LA | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Spiritual Journey LLC | Current |
Accepting new patients |
Locations
511 Sterlington Hwy
Farmerville, LA 71241
Phone (318) 309-1449
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | CIT-5671 | LA | Yes |
Addresses
Primary practice location
511 Sterlington Hwy
Farmerville, LA 71241-3122
Mailing address
5425 Highway 33
Marion, LA 71260-3126
Phone (646) 248-3852
Other providers in Farmerville, LA
- Jana Marie Guyewski
- Chassity Hamilton
- Chetsey Hamilton
- Michael Harris Jr.
- Jerry Henderson
- Kiara Hicks
- Jerome Hill
- Katelyn Pipes Hinton
- Chasity Holley
- Dennis Holman
All providers in Farmerville, LA · Addiction (Substance Use Disorder) Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.