Healthcare Provider Details
I. General information
NPI: 1598233314
Provider Name (Legal Business Name): JESSIE LANAE JAMES MAAT, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/09/2018
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 VETERANS MEMORIAL BLVD STE 310
METAIRIE LA
70005-2862
US
IV. Provider business mailing address
2408 SAINT ROCH AVE
NEW ORLEANS LA
70117-7920
US
V. Phone/Fax
- Phone: 504-220-1483
- Fax: 888-248-7189
- Phone:
- Fax: 888-248-7189
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 221700000X |
| Taxonomy | Art Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 7754 |
| License Number State | LA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: