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NPI Code Detail

MEDICARE: MS. MELINDA MARIE VINCENT BCBT,LAC

MEDICARE: MS. MELINDA MARIE VINCENT BCBT,LAC
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
1101YA0400XAddiction (Substance Use Disorder) Counselor981LA
2101YP1600XPastoral CounselorLA

General Provider Information

NPI Number : 1811261977
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MELINDA MARIE VINCENT BCBT,LAC
Provider Business Mailing Address
First Line : 1901 AIRLINE DR
Second Line : SUITE B
City : METAIRIE
State : LA
Zip : 70001-5936
Country : US
Telephone Number : 504-833-4673
Fax Number : 504-885-0400
Provider Business Practice Location Address
First Line : 1901 AIRLINE DR
Second Line : SUITE B
City : METAIRIE
State : LA
Zip : 70001-5936
Country : US
Telephone Number : 504-833-4673
Fax Number : 504-885-0400
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2012
Last Update Date : 03/06/2012

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