MEDICARE: MANDY ULERY LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PLPC 6388	LA
2	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1053868125
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANDY ULERY LPC

Provider Business Mailing Address
First Line	:	1585 3RD ST
Second Line	:
City	:	FORT POLK
State	:	LA
Zip	:	71459-5102
Country	:	US
Telephone Number	:	318-602-9401
Fax Number	:

Provider Business Practice Location Address
First Line	:	1585 3RD ST
Second Line	:
City	:	FORT POLK
State	:	LA
Zip	:	71459-5102
Country	:	US
Telephone Number	:	337-531-3923
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2016
Last Update Date	:	03/03/2026

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