Healthcare Provider Details

I. General information

NPI: 1518335199
Provider Name (Legal Business Name): CORRIE MINGES PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2015
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3152 HIGHWAY 1 APT 1
GRAND ISLE LA
70358-9753
US

IV. Provider business mailing address

2023 HIGHWAY 1
GRAND ISLE LA
70358-9717
US

V. Phone/Fax

Practice location:
  • Phone: 254-291-7721
  • Fax:
Mailing address:
  • Phone: 254-291-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701008990
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number2416
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number86508
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3780
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: