Provider Demographics
NPI:1245965698
Name:DIVINE MERCY COUNSELING CENTER
Entity type:Organization
Organization Name:DIVINE MERCY COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BALTODANO DUBEY
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-621-7914
Mailing Address - Street 1:3005 GREEN ACRES RD
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003
Mailing Address - Country:US
Mailing Address - Phone:504-621-7914
Mailing Address - Fax:504-345-2582
Practice Address - Street 1:4300 SOUTH I-10 SERVICE RD WEST
Practice Address - Street 2:SUITE 101B
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001
Practice Address - Country:US
Practice Address - Phone:504-621-7914
Practice Address - Fax:504-345-2582
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty