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General NPI Number Information
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NPI Number | 1619510344
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Entity Type | Organization
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Legal Business Name | FULL LIFE CHRISTIAN COUNSELING, LLC
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Dates
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Enumeration Date | 10/25/2019
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Last Update Date | 10/25/2019
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Provider Practice Location Address
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Address Line | 5701 VETERANS MEMORIAL BLVD
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City | METAIRIE
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State | LA
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Zip | 70003-1758
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Country | US
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Telephone | 504-635-7162
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Fax | 504-708-5684
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Provider Business Mailing Address
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Address Line | 3400 JAMES DR
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City | METAIRIE
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State | LA
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Zip | 70003-1512
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Country | US
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Telephone | 504-635-7162
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Fax | 504-708-5684
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Authorized Official
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Title or Position | OWNER
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Name | MRS. CARIANNE PRITCHETT
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Credential | LPC
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Telephone | 504-635-7162
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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 |
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License Number State |
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