Provider Demographics
NPI:1316276231
Name:BALM IN GILEAD BIG CHRISTIAN COUNSELING SERVICES LLC
Entity type:Organization
Organization Name:BALM IN GILEAD BIG CHRISTIAN COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-286-4672
Mailing Address - Street 1:1605 MURRAY ST
Mailing Address - Street 2:STE 224
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6890
Mailing Address - Country:US
Mailing Address - Phone:318-286-4672
Mailing Address - Fax:866-391-2080
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:STE 224
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-286-4672
Practice Address - Fax:866-391-2080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-24
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1807770Medicaid