Healthcare Provider Details

I. General information

NPI: 1174683064
Provider Name (Legal Business Name): REYNELDA LASHAWN GIPSON-ARMSTRONG LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 05/17/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8676 GOODWOOD BLVD STE 105
BATON ROUGE LA
70806-7914
US

IV. Provider business mailing address

8676 GOODWOOD BLVD STE 105
BATON ROUGE LA
70806-7914
US

V. Phone/Fax

Practice location:
  • Phone: 225-636-5817
  • Fax:
Mailing address:
  • Phone: 225-636-5817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4898
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: