Healthcare Provider Details

I. General information

NPI: 1316862204
Provider Name (Legal Business Name): KENI D MAREHAM PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E LULA ST
LEESVILLE LA
71446-4339
US

IV. Provider business mailing address

300 E LULA ST
LEESVILLE LA
71446-4339
US

V. Phone/Fax

Practice location:
  • Phone: 337-404-9917
  • Fax:
Mailing address:
  • Phone: 337-404-9917
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC11421
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: