Healthcare Provider Details

I. General information

NPI: 1316877962
Provider Name (Legal Business Name): ALI MARIE GERAMI MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 KALISTE SALOOM RD STE 212
LAFAYETTE LA
70508-4230
US

IV. Provider business mailing address

102 THISTLE LN
DUSON LA
70529-4409
US

V. Phone/Fax

Practice location:
  • Phone: 337-504-4974
  • Fax: 337-546-2434
Mailing address:
  • Phone: 337-322-4913
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11235
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: