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General NPI Number Information
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NPI Number | 1033886023
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY COUNSELING, LLC
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Dates
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Enumeration Date | 08/26/2021
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Last Update Date | 02/02/2024
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Provider Practice Location Address
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Address Line | 2320 DRUSILLA LANE SUITE A #1027
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City | BATON ROUGE
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State | LA
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Zip | 70809-4912
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Country | US
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Telephone | 225-399-2085
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Fax |
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Provider Business Mailing Address
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Address Line | 2320 DRUSILLA LANE SUITE A #1027
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City | BATON ROUGE
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State | LA
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Zip | 70809-4912
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Country | US
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Telephone | 225-399-2085
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JASMINE TRAVIS
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Credential | LPC
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Telephone | 225-399-2085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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