MEDICARE: GRACIANA COUNSELING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1184562670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRACIANA COUNSELING LLC

Provider Business Mailing Address
First Line	:	624 CAMBRIDGE DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-4380
Country	:	US
Telephone Number	:	337-567-2728
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 KALISTE SALOOM RD BLDG SUITE116
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-4230
Country	:	US
Telephone Number	:	337-567-2728
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHANIE LEDET GRACIANA
Credential	:	LPC
Telephone Number	:	337-567-2728

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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