Healthcare Provider Details

I. General information

NPI: 1659079788
Provider Name (Legal Business Name): BRIANA HARRELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162 OLIVER RD STE 4
MONROE LA
71201-5757
US

IV. Provider business mailing address

4951 CENTRAL AVE
MONROE LA
71203-6156
US

V. Phone/Fax

Practice location:
  • Phone: 318-340-1535
  • Fax: 318-340-1539
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPLC9529
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC9529
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC9529
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberPLC9529
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: