Kingdom Source, Llc

LBN: Kingdom Source, Llc
Kingdom Source, Llc is an health care organization with primary practice located at 2506 Johnston St , Lafayette LA 70503-3238. The organization recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Counselor is the primary health care specialty. Kingdom Source, Llc can be contacted via phone (337) 456-6166, or through Amos, Winford Louis via phone (337) 456-6166.

Contact Information

Primary practice address
2506 Johnston St Lafayette LA 70503-3238
Phone: (337) 456-6166
Fax: (337) 456-4830
Website:
Map and Directions
Authorized official contact:
Name: Amos, Winford Louis LPC, LAC, CCS
Phone: (337) 456-6166

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Pastoral 101YP1600X
Behavioral Health & Social Service Providers / Professional 101YP2500X
Behavioral Health & Social Service Providers / Social Worker 104100000X

Profile Details

NPI number 1154698892
LBN Legal business name Kingdom Source, Llc
DBA Doing business as
Authorized official Amos, Winford Louis LPC, LAC, CCS
Entity Organization
Organization subpart 1 No
Enumeration date Nov 23rd, 2011
Last updated Nov 26th, 2019 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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