Healthcare Provider Details

I. General information

NPI: 1073458584
Provider Name (Legal Business Name): JANA PHILLIPPI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2026
Last Update Date: 04/21/2026
Certification Date: 04/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70403 3RD ST
COVINGTON LA
70433-5496
US

IV. Provider business mailing address

70403 3RD ST
COVINGTON LA
70433-5496
US

V. Phone/Fax

Practice location:
  • Phone: 985-246-0013
  • Fax:
Mailing address:
  • Phone: 985-246-0013
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10837
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: