=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659891927
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | OPEN-XPRESSIONSCOUNSELING,LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2017
-----------------------------------------------------
Last Update Date | 06/27/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1 GALLERIA BLVD SUITE 1900
-----------------------------------------------------
City | METAIRIE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 70001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-339-0695
-----------------------------------------------------
Fax | 504-227-2127
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2745 LOUISE ST
-----------------------------------------------------
City | HARVEY
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-864-3845
-----------------------------------------------------
Fax | 504-227-2127
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LPC
-----------------------------------------------------
Name | MRS. MELICIA DUPAQUIER
-----------------------------------------------------
Credential | M.A.
-----------------------------------------------------
Telephone | 504-864-3845
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 5238
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------