Healthcare Provider Details

I. General information

NPI: 1801303375
Provider Name (Legal Business Name): EARNIESHA SHERELL LOTT M.ED., LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2018
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 E BOSTON ST
COVINGTON LA
70433-2900
US

IV. Provider business mailing address

209 E SAINT MARY DR
COVINGTON LA
70433-7432
US

V. Phone/Fax

Practice location:
  • Phone: 985-960-7293
  • Fax:
Mailing address:
  • Phone: 985-960-7293
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5143
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: