Healthcare Provider Details

I. General information

NPI: 1649814328
Provider Name (Legal Business Name): NORTHSHORE FAMILY RESOURCE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 01/05/2026
Certification Date: 01/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 S TYLER ST STE 7A
COVINGTON LA
70433-3050
US

IV. Provider business mailing address

47142 OAK CREEK TRCE
HAMMOND LA
70401-3627
US

V. Phone/Fax

Practice location:
  • Phone: 985-892-5664
  • Fax:
Mailing address:
  • Phone: 985-892-5664
  • Fax: 985-892-5664

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: CLAUDE ARTHUR GUILLOTTE
Title or Position: OWNER
Credential: LPC
Phone: 985-892-5664