Healthcare Provider Details

I. General information

NPI: 1619445962
Provider Name (Legal Business Name): JO-NIA CROCHET PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 12/21/2022
Certification Date: 12/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1538 W PINHOOK RD
LAFAYETTE LA
70503-3159
US

IV. Provider business mailing address

1538 W PINHOOK RD
LAFAYETTE LA
70503-3159
US

V. Phone/Fax

Practice location:
  • Phone: 337-234-4912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC9055
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberPLC9055
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC9055
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: