Provider Demographics
NPI:1043965213
Name:OM COUNSELING
Entity Type:Organization
Organization Name:OM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:DIVYA
Authorized Official - Middle Name:S
Authorized Official - Last Name:KASTURI
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:337-781-6791
Mailing Address - Street 1:1007 CAMELLIA BLVD STE I00
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7248
Mailing Address - Country:US
Mailing Address - Phone:337-781-6791
Mailing Address - Fax:800-466-0744
Practice Address - Street 1:1007 CAMELLIA BLVD STE I00
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7248
Practice Address - Country:US
Practice Address - Phone:337-781-6791
Practice Address - Fax:800-466-0744
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-16
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty