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General NPI Number Information
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NPI Number | 1003281130
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Entity Type | Organization
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Legal Business Name | IRISE COUNSELING SERVICES
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Dates
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Enumeration Date | 12/01/2015
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Last Update Date | 05/20/2024
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Provider Practice Location Address
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Address Line | 214 S BURNSIDE AVE. 203
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-647-9001
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Fax | 225-647-9001
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Provider Business Mailing Address
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Address Line | 214 S BURNSIDE AVE. 203
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-647-9001
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Fax | 225-647-9001
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Authorized Official
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Title or Position | OWNER/LPCS
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Name | DR. LAURICE DEROZAN HARRISON
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Credential | DPC, LPC-S
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Telephone | 225-647-9001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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