Provider Demographics
NPI:1710466040
Name:LATIOLAIS COUNSELING, LLC
Entity Type:Organization
Organization Name:LATIOLAIS COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:LATIOLAIS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, RPT
Authorized Official - Phone:337-288-4095
Mailing Address - Street 1:121 S AUDUBON BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2527
Mailing Address - Country:US
Mailing Address - Phone:337-288-4095
Mailing Address - Fax:337-534-8057
Practice Address - Street 1:121 S AUDUBON BLVD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2527
Practice Address - Country:US
Practice Address - Phone:337-288-4095
Practice Address - Fax:337-534-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6092261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)