| Northlake Counseling And Consulting | |
|
485 S 8th St Ponchatoula LA 70454-3415 | |
| (985) 687-5226 | |
| (866) 657-7188 |
| Full Name | Northlake Counseling And Consulting |
|---|---|
| Speciality | Counselor - Professional |
| Location | 485 S 8th St, Ponchatoula, Louisiana |
| Authorized Official Name and Position | Jessica G Gandolfo (OWNER) |
| Authorized Official Contact | 9856875226 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northlake Counseling And Consulting 902 C M Fagan Dr Unit B Hammond LA 70403-6043 Ph: (985) 687-5226 | Northlake Counseling And Consulting 485 S 8th St Ponchatoula LA 70454-3415 Ph: (985) 687-5226 |
| NPI Number | 1922369297 |
|---|---|
| Provider Enumeration Date | 06/04/2012 |
| Last Update Date | 06/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922369297 | NPI | - | NPPES |
| 1740457092 | Other | LA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 2753 (Louisiana) | Primary |
| 106H00000X | Marriage & Family Therapist | 1123 (Louisiana) | Secondary |
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