Provider Demographics
NPI:1669811956
Name:NOLA FAMILY COUNSELING, L.L.C.
Entity type:Organization
Organization Name:NOLA FAMILY COUNSELING, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT-SC, LPC-S
Authorized Official - Phone:504-616-3648
Mailing Address - Street 1:201 SAINT CHARLES AVE
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70170-1000
Mailing Address - Country:US
Mailing Address - Phone:504-616-3648
Mailing Address - Fax:
Practice Address - Street 1:201 SAINT CHARLES AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70170-1000
Practice Address - Country:US
Practice Address - Phone:504-616-3648
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-19
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC 4171101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty