Vernon Community Counseling Services, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFT368 Issued in LA

Legal business name

VERNON COMMUNITY COUNSELING SERVICES, LLC

Practice address

282 Alexandria Hwy
Leesville, LA 71446-2146

Phone

(337) 213-2393

NPI assigned

Apr 18, 2012

Organization subpart

No

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

Authorized official

Name

Debra Louise Holler, PH.D.NPI 1831517374

Title

Ceo

Phone

(337) 213-2393

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Community mental health center certification: CCN 194734

Legal name

VERNON COMMUNITY COUNSELING SERVICES, LLC

Certification status

Active

Provider type (POS)

Community mental health center

Participating since

Sep 18, 2013

Last certification

Sep 18, 2013

Ownership / control type

For profit – individual

Facility address

282 Alexandria Highway, Suite-B
Leesville, LA 71446

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Debra L Holler, PH.D., CTS, CART

  • Mental Health Counselor
  • Anchorage, AK
  • NPI 1831517374
  NPD (past) Authorized official
• Christina L Barrett

  • Social Worker
  • Lessville, LA
  • NPI 1154503340
  NPD (past)

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1770840464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1726",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714961726",
            "telephone_number": "337-213-2393",
            "fax_number": "337-404-3976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 ALEXANDRIA HWY",
            "city": "LEESVILLE",
            "state": "LA",
            "postal_code": "714462146",
            "telephone_number": "337-213-2393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VERNON COMMUNITY COUNSELING SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "HOLLER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-213-2393",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "MFT368",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace Juneau Van Dine
• Sarah Van Winkle
• Emma Vasquez
• Taylor Veillion, RBT
• Manguesh G Velingker
• Vernon Council on Aging, Inc.
• Vernon Home Health Inc
• Vernon Internal Medicine Clinic Inc
• Vernon Investment Group, LLC
• Vernon Medical Care LLC

• Community/Behavioral Health Agency in Leesville, LA
• Providers in Leesville, 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 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.