Provider Demographics
NPI:1942063086
Name:NOLAN, TRICIA CAGLE (PLPC, MED, MS)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:CAGLE
Last Name:NOLAN
Suffix:
Gender:F
Credentials:PLPC, MED, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71201-2512
Mailing Address - Country:US
Mailing Address - Phone:318-366-9312
Mailing Address - Fax:
Practice Address - Street 1:301 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71201-2512
Practice Address - Country:US
Practice Address - Phone:318-366-9312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9695101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health