Healthcare Provider Details

I. General information

NPI: 1417877713
Provider Name (Legal Business Name): LORRIE MELBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 JACKSON ST STE 134
ALEXANDRIA LA
71303-3040
US

IV. Provider business mailing address

5423 DOWNING ST APT 3G
ALEXANDRIA LA
71301-3121
US

V. Phone/Fax

Practice location:
  • Phone: 318-713-3642
  • Fax:
Mailing address:
  • Phone: 318-713-3642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: