Provider Demographics
NPI:1508391830
Name:BOLLINGER, JORDYN SERIGNE (LPC)
Entity Type:Individual
Prefix:
First Name:JORDYN
Middle Name:SERIGNE
Last Name:BOLLINGER
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 1:221 PEACOCK POINTE
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6249
Mailing Address - Country:US
Mailing Address - Phone:504-813-3892
Mailing Address - Fax:
Practice Address - Street 1:221 PEACOCK POINTE
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6249
Practice Address - Country:US
Practice Address - Phone:504-813-3892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-24
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator