Provider Demographics
NPI:1316287899
Name:ECLECTIC COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:ECLECTIC COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ROMONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:504-281-7735
Mailing Address - Street 1:P. O. BOX 0954
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70004
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6305 ELYSIAN FIELDS AVE.
Practice Address - Street 2:301 - A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70122
Practice Address - Country:US
Practice Address - Phone:504-281-7735
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-21
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health