Provider Demographics
NPI:1245001718
Name:GIACONA, MARLIN (NCC, LPC-S, LMFT)
Entity type:Individual
Prefix:MRS
First Name:MARLIN
Middle Name:
Last Name:GIACONA
Suffix:
Gender:F
Credentials:NCC, LPC-S, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4929 BURKE DR
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-2611
Mailing Address - Country:US
Mailing Address - Phone:504-329-6735
Mailing Address - Fax:
Practice Address - Street 1:3925 N I 10 SERVICE RD W
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-6867
Practice Address - Country:US
Practice Address - Phone:504-455-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-12
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1006101Y00000X
LA3169101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health