Healthcare Provider Details

I. General information

NPI: 1144753708
Provider Name (Legal Business Name): LAVERNE SENORA BRANTLEY LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2017
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3084 WESTFORK DR STE C
BATON ROUGE LA
70816-2254
US

IV. Provider business mailing address

3084 WESTFORK DR STE C
BATON ROUGE LA
70816-2254
US

V. Phone/Fax

Practice location:
  • Phone: 225-227-2502
  • Fax: 225-960-1813
Mailing address:
  • Phone: 225-227-2502
  • Fax: 225-960-1813

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC6599
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: