Provider Demographics
NPI:1003281130
Name:IRISE COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:IRISE COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR-LPC
Authorized Official - Prefix:
Authorized Official - First Name:LAURICE
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:225-978-2824
Mailing Address - Street 1:37383 SAINT MARIE AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4491
Mailing Address - Country:US
Mailing Address - Phone:225-978-2824
Mailing Address - Fax:
Practice Address - Street 1:37383 SAINT MARIE AVE
Practice Address - Street 2:
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-4491
Practice Address - Country:US
Practice Address - Phone:225-978-2824
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-01
Last Update Date:2015-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health