Healthcare Provider Details

I. General information

NPI: 1780058263
Provider Name (Legal Business Name): NANCY CROSS LPC,NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2626 CHARLES DR STE 211
CHALMETTE LA
70043-3779
US

IV. Provider business mailing address

1141 BONNABEL BLVD
METAIRIE LA
70005-1537
US

V. Phone/Fax

Practice location:
  • Phone: 504-278-4006
  • Fax: 504-278-4007
Mailing address:
  • Phone: 504-832-1643
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4373
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: