Provider Demographics
NPI:1366834764
Name:JOSIENNE P GOODROW, LLC
Entity Type:Organization
Organization Name:JOSIENNE P GOODROW, LLC
Other - Org Name:COUNSEL NOLA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOSIENNE
Authorized Official - Middle Name:PYLES
Authorized Official - Last Name:GOODROW
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-S
Authorized Official - Phone:504-754-6863
Mailing Address - Street 1:2115 CARONDELET ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5827
Mailing Address - Country:US
Mailing Address - Phone:504-371-5512
Mailing Address - Fax:
Practice Address - Street 1:2115 CARONDELET ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130
Practice Address - Country:US
Practice Address - Phone:504-371-5512
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-23
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4557251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health