MEDICARE: KIMBERLY SOILEAU M.S., PLPC

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	101YM0800X	Mental Health Counselor	PLC10685	LA

General Provider Information

NPI Number	:	1639000474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SOILEAU M.S., PLPC

Provider Business Mailing Address
First Line	:	2507 HODGES ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7309
Country	:	US
Telephone Number	:	337-426-0741
Fax Number	:	318-414-2298

Provider Business Practice Location Address
First Line	:	2507 HODGES ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70601-7309
Country	:	US
Telephone Number	:	337-426-0741
Fax Number	:	318-414-2298

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2026
Last Update Date	:	05/28/2026

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