SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC (NPI# 1104459064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104459064 |
| Entity Type | Organization |
| Organization Name | SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC |
| Practice Address |
323 Evergreen St Ste B Bunkie LA 71322-1307 |
| Mailing Address |
4601 Bluebonnet Blvd Ste B Baton Rouge LA 70809-9656 |
| Practice Telephone | 3183463143 |
| Practice Fax Number | 3182954017 |
| Mailing Telephone | 2258104040 |
| Mailing Fax Number | 2258104050 |
| Enumeration Date | 2020-02-19 |
| Last Update Date | 2020-02-19 |
| Authorized Official Name | MR. PHILLIP SEAN WENDELL (CEO) |
| Authorized Official Telephone | 2258104040 |
| Is Organization Subpart | Y |
| Parent Organization Name | SPRINGLAKE BEHAVIORAL HEALTH BUNKIE LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2700227 | 05 | |
| MEDICARE | 194112 | 01 |
| Other Name | Type Code |
|---|---|
| Beacon Behavioral Outpatient - Bunkie | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184044430 | Springlake Behavioral Health Bunkie LLC | Psychiatric Hospital | 323 Evergreen St Ste B, Bunkie, LA 71322-1307 | 2014-04-24 |
| Street Address |
323 EVERGREEN ST STE B |
| City | BUNKIE |
| State | LA |
| Zip Code | 71322-1307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184044430 | Springlake Behavioral Health Bunkie LLC | Psychiatric Hospital | 323 Evergreen St Ste B, Bunkie, LA 71322-1307 | 2014-04-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053945642 | Sarah Ann Hillman | Physical Therapist | 427 Evergreen Street, Bunkie, LA 71322 | 2020-02-24 |
| 1477054005 | Michelle Ciudadano | Case Manager/Care Coordinator | 109 Chevy Lane, Suite C, Bunkie, LA 71322 | 2018-02-28 |
| 1003332198 | Chelsea Garin | Counselor | 109 Chevy Lane, Suite C, Bunkie, LA 71322 | 2017-08-21 |
| 1457876872 | Tayressha Joy Harmason | Community/Behavioral Health | 1140 Shirley Road, Bunkie, LA 71322 | 2017-08-07 |
| 1942731294 | Adranell Christmas | Non-emergency Medical Transport (VAN) | 303 Martin Luther King Dr, Bunkie, LA 71322 | 2017-03-27 |
| 1477916252 | Bertha Wilson | Counselor | 313 James Street, Bunkie, LA 71322 | 2016-03-30 |
| 1831516087 | Casey Ann Kendall | Pharmacist | 109 Chevy Lane Suite B, Bunkie, LA 71322 | 2014-03-26 |
| 1952642407 | Stephanie L Simmons | Registered Nurse | 1536 Bordelon Rd, Bunkie, LA 71322 | 2013-03-08 |
| 1689861908 | Assisted Living Concepts Inc | Assisted Living Facility | 650 Pershing Avenue, Bunkle, LA 71322 | 2007-10-01 |
| 1932282126 | Pulmonary Services Inc | Durable Medical Equipment & Medical Supplies | 746 Nw Main, #9, Bunkie, LA 71322 | 2006-10-23 |
| Find all providers in zip 71322 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013379973 | Lashaitrend Berry | Counselor | 408 Floyd St, Bunkie, LA 71322-1604 | 2016-03-22 |
| 1811358898 | Karen Mccoy | Counselor | 309 Rose St, Bunkie, LA 71322-1848 | 2016-03-17 |
| 1518328590 | Tomika Simmons | Counselor | 310 Rose St, Bunkie, LA 71322-1849 | 2016-03-17 |
| 1336509280 | Trista Gordon | Counselor | 611 Patton St, Bunkie, LA 71322-2369 | 2016-03-03 |
| 1700349743 | Louella Ann Chambers | Counselor | 1140 Shirley Rd, Bunkie, LA 71322-1545 | 2019-04-08 |
| 1962986265 | Brittani N Johnson | Counselor | 1140 Shirley Rd, Bunkie, LA 71322-1545 | 2018-09-21 |
| 1821502238 | Roman Dale Hill | Counselor | 1140 Shirley Rd, Bunkie, LA 71322-1545 | 2017-11-21 |
| 1295268597 | Thesia Batiste | Counselor | 611 Patton St, Bunkie, LA 71322-2369 | 2017-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447222 | Caitlin Mcginn Seelie | Counselor | 1932 Audubon St, New Orleans, LA 70118-5516 | 2020-11-06 |
| 1578160024 | Benjamin Ng | Counselor | 8758 Field Dr, Baton Rouge, LA 70809-2903 | 2020-10-07 |
| 1275130767 | Emily Ludwin Miller | Counselor | 1941 Congress St, New Orleans, LA 70117-5927 | 2020-10-07 |
| 1932716263 | Julie Ireland | Counselor | 1264 Staci Ln, Sulphur, LA 70665-7951 | 2020-09-30 |
| 1639786502 | Erik Rasmussen | Counselor | 670 Albemarle Dr Ste 700, Shreveport, LA 71106-5946 | 2020-09-25 |
| 1689280174 | Amy Giles Arceneaux | Counselor | 850 Kaliste Saloom Rd Bldg Ste 204, Lafayette, LA 70508-4230 | 2020-09-20 |
| 1619582640 | Lisha Kerr Jacobsen | Counselor | 7936 Wrenwood Drive, Bldg # A, Baton Rouge, LA 70809 | 2020-09-15 |
| 1528673258 | Benjamin R Taylor Jr. | Counselor | 8728 Waters Edge Ave, Baker, LA 70714-6443 | 2020-09-10 |
| 1144833906 | Kelli Cain | Counselor | 919 Doc Prejean St, Scott, LA 70583-5133 | 2020-08-31 |
| 1760095459 | Julie Giroir Galloway | Counselor | 4906 Ambassador Caffery Pkwy Bldg B, Lafayette, LA 70508-6962 | 2020-08-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.