Provider Demographics
NPI:1770846917
Name:GAIDOS, NICOLE SONGY (MA, NCC, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:SONGY
Last Name:GAIDOS
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 W IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4739
Mailing Address - Country:US
Mailing Address - Phone:504-615-4275
Mailing Address - Fax:
Practice Address - Street 1:700 PAPWORTH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005-3009
Practice Address - Country:US
Practice Address - Phone:504-615-4275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional