Provider Demographics
NPI:1669712469
Name:QUARLES, JOELLEN MARIE (LPC, LMFT)
Entity type:Individual
Prefix:MRS
First Name:JOELLEN
Middle Name:MARIE
Last Name:QUARLES
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 N LAKE CT
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-6535
Mailing Address - Country:US
Mailing Address - Phone:337-477-8547
Mailing Address - Fax:
Practice Address - Street 1:308 N LAKE CT
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-6535
Practice Address - Country:US
Practice Address - Phone:337-477-8547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-15
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2868101YM0800X
LA877106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist