Provider Demographics
NPI:1568830669
Name:PROCTOR, ALISON M (P-LPC)
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:PROCTOR
Suffix:
Gender:F
Credentials:P-LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2238 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-3606
Mailing Address - Country:US
Mailing Address - Phone:985-690-6622
Mailing Address - Fax:985-690-6662
Practice Address - Street 1:2321 N HULLEN ST
Practice Address - Street 2:SUITE B
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-1982
Practice Address - Country:US
Practice Address - Phone:504-941-7580
Practice Address - Fax:504-941-7585
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-04
Last Update Date:2015-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5775101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)