Provider Demographics
NPI:1336779461
Name:BAREFOOT COUNSELING, LLC
Entity Type:Organization
Organization Name:BAREFOOT COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:MAILLOUX
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:LAC, NCC
Authorized Official - Phone:985-718-4507
Mailing Address - Street 1:311 SCOTCHPINE DR
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70471-2548
Mailing Address - Country:US
Mailing Address - Phone:504-444-4571
Mailing Address - Fax:
Practice Address - Street 1:400 MARINERS PLAZA DR STE 409C
Practice Address - Street 2:
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70448-6849
Practice Address - Country:US
Practice Address - Phone:985-718-4507
Practice Address - Fax:504-617-7878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty