Provider Demographics
NPI:1275990236
Name:NOLAN, CARLY (LPC)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:
Last Name:NOLAN
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 1:654 BROCKENBRAUGH CT
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005-2712
Mailing Address - Country:US
Mailing Address - Phone:504-298-8367
Mailing Address - Fax:
Practice Address - Street 1:654 BROCKENBRAUGH CT
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-2712
Practice Address - Country:US
Practice Address - Phone:504-298-8367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2019-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5090101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health