Provider Demographics
NPI:1881091114
Name:COUSIN, NICOLE
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:COUSIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 POYDRAS ST
Mailing Address - Street 2:SUITE 2411
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7579
Mailing Address - Country:US
Mailing Address - Phone:504-230-9848
Mailing Address - Fax:504-658-4502
Practice Address - Street 1:2651 POYDRAS ST
Practice Address - Street 2:SUITE 2411
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7579
Practice Address - Country:US
Practice Address - Phone:504-230-9848
Practice Address - Fax:504-658-4502
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2014-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor