Provider Demographics
NPI:1093926891
Name:COUNSELING ASSOCIATES OF NELA
Entity Type:Organization
Organization Name:COUNSELING ASSOCIATES OF NELA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:AYCOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-387-1850
Mailing Address - Street 1:1900 LAMY LN
Mailing Address - Street 2:SUITE J
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-9207
Mailing Address - Country:US
Mailing Address - Phone:318-387-1850
Mailing Address - Fax:318-387-1864
Practice Address - Street 1:1900 LAMY LN
Practice Address - Street 2:SUITE J
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-9207
Practice Address - Country:US
Practice Address - Phone:318-387-1850
Practice Address - Fax:318-387-1864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty