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NPI Code Detail

MEDICARE: CARLY NOLAN LPC

MEDICARE: CARLY NOLAN LPC
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
1101YM0800XMental Health Counselor5090LA

General Provider Information

NPI Number : 1275990236
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARLY NOLAN LPC
Provider Business Mailing Address
First Line : 654 BROCKENBRAUGH CT
Second Line :
City : METAIRIE
State : LA
Zip : 70005-2712
Country : US
Telephone Number : 504-298-8367
Fax Number :
Provider Business Practice Location Address
First Line : 654 BROCKENBRAUGH CT
Second Line :
City : METAIRIE
State : LA
Zip : 70005-2712
Country : US
Telephone Number : 504-298-8367
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/21/2016
Last Update Date : 04/28/2019

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