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NPI 1326948944

NPI 1326948944 : SOVEREIGN COUNSELING & WELLNESS, LLC : FORT POLK, LA

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General NPI Number Information
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    NPI Number           |    1326948944
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    Entity Type          |    Organization 
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    Legal Business Name  |    SOVEREIGN COUNSELING & WELLNESS, LLC 
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Dates
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    Enumeration Date     |    11/07/2026
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    Last Update Date     |    11/07/2026
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Provider Practice Location Address
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    Address Line         |    6457 LEADBETTER CT APT B 
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    City                 |    FORT POLK
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    State                |    LA
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    Zip                  |    71459-8415
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    Country              |    US
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    Telephone            |    337-570-2457
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    6457 LEADBETTER CT APT B 
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    City                 |    FORT POLK
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    State                |    LA
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    Zip                  |    71459-8415
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    Country              |    US
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    Telephone            |    337-570-2457
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     LATASHA  LASSITER 
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    Credential           |    LPC
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    Telephone            |    337-570-2457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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