Provider Demographics
NPI:1265974893
Name:NARCISSE, MARLISKA DECLOUETTE (MA)
Entity type:Individual
Prefix:
First Name:MARLISKA
Middle Name:DECLOUETTE
Last Name:NARCISSE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2798 ONEAL LN
Mailing Address - Street 2:STE. 8
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-3407
Mailing Address - Country:US
Mailing Address - Phone:225-751-5412
Mailing Address - Fax:225-751-5847
Practice Address - Street 1:2798 ONEAL LN
Practice Address - Street 2:STE. 8
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-3407
Practice Address - Country:US
Practice Address - Phone:225-751-5412
Practice Address - Fax:225-751-5847
Is Sole Proprietor?:No
Enumeration Date:2016-11-14
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5290101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional