NPIMap

Organization Active NPI

Ascension Parish Mental Health and Addictive Disorders Clinic

  • Community/Behavioral Health Agency
  • Gonzales, LA
National Provider Identifier
1770753303
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
260A Issued in LA
Legal business name
ASCENSION PARISH MENTAL HEALTH AND ADDICTIVE DISORDERS CLINIC
Practice address
1112 S. East Ascension Complex Avenue
Gonzales, LA 70737-4265
Phone
(225) 621-5775
NPI assigned
Mar 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Dr. Susan C. Mittendorf, PH.D., LCSW
Title
Director
Phone
(225) 621-1113

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 260A LA Primary

Addresses

Primary practice location

1112 S. East Ascension Complex Avenue
Gonzales, LA 70737-4265

Mailing address

1112 S. East Ascension Complex Avenue
Gonzales, LA 70737-4265
Phone (225) 621-5775

National Provider Directory

National Provider Directory
Tax ID family
Ascension Counseling and Substance Abuse Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1112 E Ascension Complex Blvd
Gonzales, LA 70737
Phone (225) 621-5770

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1770753303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 S. EAST ASCENSION COMPLEX AVENUE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374265",
            "telephone_number": "225-621-5775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S. EAST ASCENSION COMPLEX AVENUE",
            "city": "GONZALES",
            "state": "LA",
            "postal_code": "707374265",
            "telephone_number": "225-621-5775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASCENSION PARISH MENTAL HEALTH AND ADDICTIVE DISORDERS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "MITTENDORF",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "225-621-1113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "260A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gonzales, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.