Healthcare Provider Details

I. General information

NPI: 1285005348
Provider Name (Legal Business Name): RANICSHA ALLEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/15/2015
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2448 JOHNSTON ST STE B
LAFAYETTE LA
70503-2756
US

IV. Provider business mailing address

137 OAK HAVEN DR
LAFAYETTE LA
70507-4525
US

V. Phone/Fax

Practice location:
  • Phone: 337-233-7250
  • Fax: 337-233-7104
Mailing address:
  • Phone: 337-501-1106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC10097
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC10097
License Number StateLA
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10097
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: