Provider Demographics
NPI:1720751324
Name:BLANCHARD, ANTONINA (LPC)
Entity Type:Individual
Prefix:
First Name:ANTONINA
Middle Name:
Last Name:BLANCHARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:BLANCHARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:621 HONORE DR
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-1606
Mailing Address - Country:US
Mailing Address - Phone:504-249-0018
Mailing Address - Fax:
Practice Address - Street 1:621 HONORE DR
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-1606
Practice Address - Country:US
Practice Address - Phone:504-249-0018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-29
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6188101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health