Healthcare Provider Details

I. General information

NPI: 1477956126
Provider Name (Legal Business Name): BRUCE PROFESSIONAL COUNSELING SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2014
Last Update Date: 06/12/2023
Certification Date: 06/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

824 ELMWOOD PARK BLVD STE 150
HARAHAN LA
70123-3360
US

IV. Provider business mailing address

824 ELMWOOD PARK BLVD STE 150
HARAHAN LA
70123-3360
US

V. Phone/Fax

Practice location:
  • Phone: 504-733-0009
  • Fax: 504-733-0012
Mailing address:
  • Phone: 504-733-0009
  • Fax: 504-733-0012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. TINA YOLANDA BRUCE
Title or Position: CEO
Credential: NCC, LPC
Phone: 318-414-3065