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General NPI Number Information
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NPI Number | 1548650534
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Entity Type | Individual
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Provider Name | NICOLETTE PAUL MS,CI
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Gender | Female
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Dates
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Enumeration Date | 01/28/2015
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 28315 S FROST RD
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City | LIVINGSTON
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State | LA
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Zip | 70754-2612
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Country | US
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Telephone | 225-283-1356
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Fax | 225-683-1310
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Provider Business Mailing Address
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Address Line | 2424 DRUSILLA LN APT 127
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City | BATON ROUGE
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State | LA
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Zip | 70809-1480
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Country | US
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Telephone | 337-292-7138
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 5835
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5835
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License Number State | LA
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