Provider Demographics
NPI:1720339633
Name:INTERDEPENDENCE COUNSELING LLC
Entity Type:Organization
Organization Name:INTERDEPENDENCE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:HYACINTH
Authorized Official - Middle Name:
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW BACS
Authorized Official - Phone:504-994-7161
Mailing Address - Street 1:PO BOX 8734
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70182-8734
Mailing Address - Country:US
Mailing Address - Phone:504-994-7161
Mailing Address - Fax:
Practice Address - Street 1:10001 LAKE FOREST BLVD
Practice Address - Street 2:SUITE 308
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-6212
Practice Address - Country:US
Practice Address - Phone:504-994-7161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA47191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1871826552OtherNPI INDIVIDUAL
LA600767715OtherMAGELLAN HEALTH SERVICES
LA4719OtherLA STATE BOARD OF SOCIAL WORK EXAMINERS