Provider Demographics
NPI:1689949380
Name:MORAN, TASHA NICOLE (LPC)
Entity Type:Individual
Prefix:MS
First Name:TASHA
Middle Name:NICOLE
Last Name:MORAN
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 1:2888 BRIGHTSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70820-3509
Mailing Address - Country:US
Mailing Address - Phone:225-757-3227
Mailing Address - Fax:225-757-3220
Practice Address - Street 1:2888 BRIGHTSIDE DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70820-3509
Practice Address - Country:US
Practice Address - Phone:225-757-3227
Practice Address - Fax:225-757-3220
Is Sole Proprietor?:No
Enumeration Date:2012-03-13
Last Update Date:2014-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3097101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor