=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336499755
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NEW ORLEANS COUNSELING & HYPNOSIS CENTER, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2012
-----------------------------------------------------
Last Update Date | 08/20/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4038 CANAL ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70119-6021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-669-1980
-----------------------------------------------------
Fax | 888-959-6762
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4038 CANAL ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70119-6021
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-669-1980
-----------------------------------------------------
Fax | 888-959-6762
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | HOPE GERSOVITZ
-----------------------------------------------------
Credential | LPC, LMFT
-----------------------------------------------------
Telephone | 504-669-1980
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | LPC 2811
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------