Provider Demographics
NPI:1952089112
Name:CAHILL, JACQUELINE NICOLE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:NICOLE
Last Name:CAHILL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 STUBBS VINSON RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71203-8584
Mailing Address - Country:US
Mailing Address - Phone:318-547-2788
Mailing Address - Fax:318-412-6006
Practice Address - Street 1:3504 HIGHWAY 165 BYP
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71202-6019
Practice Address - Country:US
Practice Address - Phone:318-547-2788
Practice Address - Fax:318-412-6006
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor