Healthcare Provider Details
I. General information
NPI: 1245602861
Provider Name (Legal Business Name): ANDREIKA L TALBERT LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/22/2015
Last Update Date: 04/04/2025
Certification Date: 04/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1162 OLIVER RD STE 4
MONROE LA
71201-5757
US
IV. Provider business mailing address
1162 OLIVER RD STE 4
MONROE LA
71201-5757
US
V. Phone/Fax
- Phone: 318-340-1535
- Fax:
- Phone: 318-340-1535
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 7538 |
| License Number State | LA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: