Provider Demographics
NPI:1700529211
Name:TRISHA BOTELLO, LPC LLC
Entity Type:Organization
Organization Name:TRISHA BOTELLO, LPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:337-517-7339
Mailing Address - Street 1:516 N HENNESSEY ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-4632
Mailing Address - Country:US
Mailing Address - Phone:337-517-7339
Mailing Address - Fax:
Practice Address - Street 1:516 N HENNESSEY ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-4632
Practice Address - Country:US
Practice Address - Phone:337-517-7339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)