| Provider / Organization | NPI | Date Certified |
|---|---|---|
| LAKEISHA RENEE GREEN | 1154072668 | 2022-01-16 |
Lakeisha Renee Green is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1154072668. Registration indicates Lakeisha Renee Green is a provider of access to substance use disorder providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Addiction (Substance Use Disorder),, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Addiction Substance Use Disorder, Behavioral Health & Social Service Providers) (Counselor, ) (Other Service Providers, Case Manager/Care Coordinator) (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers)
| Entity Type | Individual |
| Provider Name | Lakeisha Renee Green RAC |
| Practice Office Address | 710 VERSAILLES BLVD ALEXANDRIA, LA US |
| Practice Office Telephone | 3184494474 |
| Practice Office Fax | 3184494472 |
| Mailing Address | 710 VERSAILLES BLVD ALEXANDRIA, LA 713032351 US |
| Business Telephone | 3373715348 |
| Code | Practice | License No State |
|---|---|---|
| 101YA0400X | Access to Substance Use Disorder Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Addiction (Substance Use Disorder), Behavioral Health/Substance Abuse/Psychiatry Counselor Addiction Substance Use Disorder Behavioral Health & Social Service Providers Counselor | RAC-5055
LA |
| 171M00000X PRIMARY | Other Service Providers Case Manager/Care Coordinator Case Manager/Care Coordinator All Other Specialties & Provider Types Case Manager/Care Coordinator Other Service Providers |