| Brenda Poche Licensed Professional Counselor, Llc | |
|
3312 Kaliste Saloom Rd Bldg 1 Lafayette LA 70508-7449 | |
| (337) 534-0727 | |
| (337) 534-0737 |
| Full Name | Brenda Poche Licensed Professional Counselor, Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 3312 Kaliste Saloom Rd Bldg 1, Lafayette, Louisiana |
| Authorized Official Name and Position | Brenda Poche (OWNER) |
| Authorized Official Contact | 3375340727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Brenda Poche Licensed Professional Counselor, Llc 3312 Kaliste Saloom Rd Bldg 1 Lafayette LA 70508-7449 Ph: (337) 534-0727 | Brenda Poche Licensed Professional Counselor, Llc 3312 Kaliste Saloom Rd Bldg 1 Lafayette LA 70508-7449 Ph: (337) 534-0727 |
| NPI Number | 1568283315 |
|---|---|
| Provider Enumeration Date | 10/23/2024 |
| Last Update Date | 10/23/2024 |
| Certification Date | 10/23/2024 |
| Medicare PECOS PAC ID | 0648703728 |
|---|---|
| Medicare Enrollment ID | O20241028002921 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568283315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Brenda Poche |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407692726 PECOS PAC ID: 5890228977 Enrollment ID: I20241028003193 |
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