Provider Demographics
NPI:1164948386
Name:A LIFE CHOICE FOR PERSONAL ENHANCEMENT, LLC
Entity Type:Organization
Organization Name:A LIFE CHOICE FOR PERSONAL ENHANCEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROGRAM DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:MARSHALL-FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S, LMFT
Authorized Official - Phone:504-994-9193
Mailing Address - Street 1:401 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-2558
Mailing Address - Country:US
Mailing Address - Phone:504-362-0504
Mailing Address - Fax:504-463-4086
Practice Address - Street 1:401 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-2558
Practice Address - Country:US
Practice Address - Phone:504-362-0504
Practice Address - Fax:504-463-4086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2203783236171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty