| Provider / Organization | NPI | Date Certified |
|---|---|---|
| DERRICK ALLEN | 1174993257 | 2015-10-01 |
Derrick Allen is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1174993257. Registration indicates Derrick Allen is a provider of services with a specialization in Other Service Providers, Case Manager/Care Coordinator (Case Manager/Care Coordinator, ) (All Other Specialties & Provider Types, ) (Case Manager/Care Coordinator, Other Service Providers) 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, )
| Entity Type | Individual |
| Provider Name | Mr. Derrick Allen |
| Practice Office Address | 8706 JEFFERSON HWY STE A BATON ROUGE, LA US |
| Practice Office Telephone | 2259269706 |
| Practice Office Fax | 2259269708 |
| Mailing Address | PO BOX 423 BAKER, LA 707040423 US |
| Business Telephone | 2257723334 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 524 S Burnside Ave | Gonzales, LA 707373448 | 2252574677 |
| Code | Practice | License No State |
|---|---|---|
| 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 | |
| 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 | 5113
LA |