Healthcare Provider Details

I. General information

NPI: 1104296953
Provider Name (Legal Business Name): NED MICHAEL JABOUR SR. PH.D., LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2015
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1105 HUDSON LN
MONROE LA
71201-6003
US

IV. Provider business mailing address

1105 HUDSON LN
MONROE LA
71201-6003
US

V. Phone/Fax

Practice location:
  • Phone: 318-322-6500
  • Fax: 318-322-5118
Mailing address:
  • Phone: 318-322-6500
  • Fax: 318-322-5118

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number68
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: