Healthcare Provider Details

I. General information

NPI: 1467772814
Provider Name (Legal Business Name): FIRST COUNSEL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2010
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 KALISTE SALOOM RD SUITE C-8
LAFAYETTE LA
70508-6137
US

IV. Provider business mailing address

1720 KALISTE SALOOM RD SUITE C-8
LAFAYETTE LA
70508-6137
US

V. Phone/Fax

Practice location:
  • Phone: 337-989-0933
  • Fax: 337-989-8458
Mailing address:
  • Phone: 337-989-0933
  • Fax: 337-989-8458

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number2184
License Number StateLA

VIII. Authorized Official

Name: MS. EMILIA J BELLONE
Title or Position: OWNER
Credential: MSW, LCSW
Phone: 337-989-0933