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General NPI Number Information
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NPI Number | 1598111668
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Entity Type | Individual
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Provider Name | MICHELLE MARTINEZ DICKENS MA,LPC,NCC
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Gender | Female
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Dates
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Enumeration Date | 05/09/2016
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Last Update Date | 10/17/2025
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Provider Practice Location Address
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Address Line | 2235 POYDRAS ST STE A
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City | NEW ORLEANS
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State | LA
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Zip | 70119-7561
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Country | US
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Telephone | 504-814-8001
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Fax | 504-814-8002
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Provider Business Mailing Address
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Address Line | 4700 WICHERS DR STE 304
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City | MARRERO
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State | LA
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Zip | 70072-3054
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Country | US
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Telephone | 504-309-3262
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6583
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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 | C10325
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License Number State | OR
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