Healthcare Provider Details

I. General information

NPI: 1063349504
Provider Name (Legal Business Name): LIBERATING MINDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1924 CORPORATE SQUARE DR STE F
SLIDELL LA
70458-3164
US

IV. Provider business mailing address

1924 CORPORATE SQUARE DR STE F
SLIDELL LA
70458-3164
US

V. Phone/Fax

Practice location:
  • Phone: 985-275-9722
  • Fax:
Mailing address:
  • Phone: 985-275-9722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TOCCARA L GARDNER
Title or Position: OWNER
Credential:
Phone: 504-460-8329