Healthcare Provider Details

I. General information

NPI: 1477463990
Provider Name (Legal Business Name): ALYSSA HA
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10202 PERKINS ROWE STE E1607231
BATON ROUGE LA
70810-2067
US

IV. Provider business mailing address

10211 SPRINGDALE AVE
BATON ROUGE LA
70810-0731
US

V. Phone/Fax

Practice location:
  • Phone: 225-800-2989
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: