Healthcare Provider Details

I. General information

NPI: 1770132474
Provider Name (Legal Business Name): PURPOSEFUL COUNSELING CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 09/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 S WASHINGTON ST
MARKSVILLE LA
71351-3022
US

IV. Provider business mailing address

104 S WASHINGTON ST
MARKSVILLE LA
71351-3022
US

V. Phone/Fax

Practice location:
  • Phone: 318-305-4853
  • Fax:
Mailing address:
  • Phone: 318-305-4853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: CARMEN GREENHOUSE
Title or Position: OWNER
Credential: LPC, LMFT
Phone: 318-264-1618