=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740043975
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA ARSENAUX LPC, NCC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/31/2024
-----------------------------------------------------
Last Update Date | 01/31/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3811 N GALVEZ ST
-----------------------------------------------------
City | NEW ORLEANS
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70117-5503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-355-0210
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 730 EIGHTH ST
-----------------------------------------------------
City | WESTWEGO
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70094-4447
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 504-376-3579
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number | 5207
-----------------------------------------------------
License Number State | LA
-----------------------------------------------------