Provider Demographics
NPI:1790367241
Name:TREE OF LIFE COUNSELING AND CONSULTING
Entity Type:Organization
Organization Name:TREE OF LIFE COUNSELING AND CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:MICAELA
Authorized Official - Last Name:ISTRE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, NCC
Authorized Official - Phone:337-703-2806
Mailing Address - Street 1:3112 W PINHOOK RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3443
Mailing Address - Country:US
Mailing Address - Phone:337-703-2806
Mailing Address - Fax:337-205-4559
Practice Address - Street 1:3112 W PINHOOK RD STE B
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3443
Practice Address - Country:US
Practice Address - Phone:337-703-2806
Practice Address - Fax:337-205-4559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-24
Last Update Date:2021-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty