=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598189896
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRITTNEY REASON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/07/2014
-----------------------------------------------------
Last Update Date | 08/06/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 206 1/2 E THOMAS ST
-----------------------------------------------------
City | HAMMOND
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70401-3316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-542-3457
-----------------------------------------------------
Fax | 985-542-3680
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 20197 CAMDEN LN
-----------------------------------------------------
City | HAMMOND
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70403-0553
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 985-507-0311
-----------------------------------------------------
Fax | 985-542-3680
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 4792
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------