Healthcare Provider Details

I. General information

NPI: 1043133366
Provider Name (Legal Business Name): JACLYN COLE PLPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 SAINT CHARLES AVE # 3D
NEW ORLEANS LA
70130-3411
US

IV. Provider business mailing address

7825 SYCAMORE ST
NEW ORLEANS LA
70118-4226
US

V. Phone/Fax

Practice location:
  • Phone: 504-822-5454
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC11401
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: