Provider Demographics
NPI:1821597352
Name:VALID VOICES COUNSELING AGENCY
Entity Type:Organization
Organization Name:VALID VOICES COUNSELING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOBO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-434-5880
Mailing Address - Street 1:112 E CAROLINA AVE STE E
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-3824
Mailing Address - Country:US
Mailing Address - Phone:318-434-5880
Mailing Address - Fax:318-224-9055
Practice Address - Street 1:112 E CAROLINA AVE STE E
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-3824
Practice Address - Country:US
Practice Address - Phone:318-434-5880
Practice Address - Fax:318-224-9055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-10
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4994101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA14175603Medicaid