Healthcare Provider Details

I. General information

NPI: 1982261897
Provider Name (Legal Business Name): ANGELA MARIE YESSO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2019
Last Update Date: 07/31/2025
Certification Date: 07/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6522 W MAIN ST
HOUMA LA
70360-2267
US

IV. Provider business mailing address

6522 W MAIN ST
HOUMA LA
70360-2267
US

V. Phone/Fax

Practice location:
  • Phone: 985-804-7403
  • Fax:
Mailing address:
  • Phone: 985-804-7403
  • Fax: 985-293-7840

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6622
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number6622
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: