Healthcare Provider Details

I. General information

NPI: 1437205572
Provider Name (Legal Business Name): MICHAEL H. GOOTEE MA, LPC, LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/14/2020
Certification Date: 08/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 W ESPLANADE AVE S SUITE 512
METAIRIE LA
70002-3454
US

IV. Provider business mailing address

3330 W ESPLANADE AVE S SUITE 512
METAIRIE LA
70002-3454
US

V. Phone/Fax

Practice location:
  • Phone: 504-451-8870
  • Fax: 337-935-6297
Mailing address:
  • Phone: 504-451-8870
  • Fax: 337-935-6297

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number634
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number310
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: