Provider Demographics
NPI:1326564329
Name:COURVILLE, JAMIE B (MS, PLPC, CRC)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:B
Last Name:COURVILLE
Suffix:
Gender:F
Credentials:MS, PLPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 YOUREE DR STE 110
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3600
Mailing Address - Country:US
Mailing Address - Phone:318-423-3408
Mailing Address - Fax:
Practice Address - Street 1:1017 SAINT JOHN ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6711
Practice Address - Country:US
Practice Address - Phone:337-261-2300
Practice Address - Fax:337-261-9080
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2017-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6451101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor