Ladetrick Provo is a Counselor based in Baton Rouge, LA. Ladetrick Provo practices in Baton Rouge, LA. The NPI Number for Ladetrick Provo is 1184155731 and holds a License No. (Louisiana).
The current practice location address for Ladetrick Provo is 5476 Summer Dr, Baton Rouge, LA and can be reached out via phone at 225-333-7899.
Location: 5476 Summer Dr, Baton Rouge, LA, 70812-3046
Provider Profile Details
NPI Number
1184155731
Provider Name
Ladetrick Provo
Credential
Provider Entity Type
Individual
Gender
Female
Address
5476 Summer Dr, Baton Rouge, LA, 70812-3046
Phone Number
225-333-7899
Fax Number
Provider Enumeration Date
03/24/2017
Last Update Date
03/09/2024
Provider's Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000 | 05 | LA |
Provider Business Practice Location Address Details
Address
5476 Summer Dr
City
State
Zip
70812-3046
Phone Number
225-333-7899
Fax Number
Provider Business Mailing Address Details
Address
5476 Summer Dr
City
State
Zip
70812-3046
Phone Number
225-333-7899
Fax Number
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
-
Taxonomy
License No.
()
Definition
A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master's degree and clinical experience and supervision for licensure or certification.
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