Provider Demographics
NPI:1093475683
Name:FOREMAN, MELANIE (LPC)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:
Last Name:FOREMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1510 CHEMIN AGREABLE RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-6202
Mailing Address - Country:US
Mailing Address - Phone:337-345-1305
Mailing Address - Fax:337-201-9315
Practice Address - Street 1:221 RUE DE JEAN STE 126A
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-8501
Practice Address - Country:US
Practice Address - Phone:337-345-1305
Practice Address - Fax:337-201-9315
Is Sole Proprietor?:No
Enumeration Date:2021-12-22
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8884101YM0800X, 101Y00000X, 101YP2500X, 101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA8884OtherLPC