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General NPI Number Information
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NPI Number | 1699743286
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Entity Type | Individual
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Provider Name | GEORGE M WOLCOTT LPC, LMFT, EDD
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Gender | Male
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Dates
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Enumeration Date | 03/09/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 820 JORDAN ST STE. 570
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City | SHREVEPORT
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State | LA
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Zip | 71101-4518
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Country | US
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Telephone | 318-221-4455
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Fax | 318-221-4459
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Provider Business Mailing Address
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Address Line | 820 JORDAN ST STE. 570
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City | SHREVEPORT
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State | LA
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Zip | 71101-4518
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Country | US
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Telephone | 318-221-4455
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Fax | 318-221-4459
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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 | 106
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 15
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License Number State | LA
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