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General NPI Number Information
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NPI Number | 1245001718
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Entity Type | Individual
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Provider Name | MARLIN GIACONA NCC, LPC-S, LMFT
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Gender | Female
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Dates
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Enumeration Date | 01/12/2024
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Last Update Date | 01/18/2024
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Provider Practice Location Address
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Address Line | 3925 N I 10 SERVICE RD W
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City | METAIRIE
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State | LA
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Zip | 70002-6867
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Country | US
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Telephone | 504-455-2446
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Fax |
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Provider Business Mailing Address
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Address Line | 4929 BURKE DR
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City | METAIRIE
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State | LA
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Zip | 70003-2611
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Country | US
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Telephone | 504-329-6735
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 1006
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3169
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3169
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License Number State | LA
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