Provider Demographics
NPI:1336553700
Name:LOUISIANA COUNSELING AGENCY
Entity Type:Organization
Organization Name:LOUISIANA COUNSELING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:PEPITONE
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:318-541-0778
Mailing Address - Street 1:2007 MACARTHUR DRIVE
Mailing Address - Street 2:BUILDING 7, SUITE 4
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303
Mailing Address - Country:US
Mailing Address - Phone:318-792-8275
Mailing Address - Fax:
Practice Address - Street 1:5205 OLD BOYCE RD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-5062
Practice Address - Country:US
Practice Address - Phone:318-541-0778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA00117151251300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)