MEDICARE: COUNSELING ASSOCIATES OF NELA

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1093926891
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING ASSOCIATES OF NELA

Provider Business Mailing Address
First Line	:	1900 LAMY LN
Second Line	:	SUITE J
City	:	MONROE
State	:	LA
Zip	:	71201-9207
Country	:	US
Telephone Number	:	318-387-1850
Fax Number	:	318-387-1864

Provider Business Practice Location Address
First Line	:	1900 LAMY LN
Second Line	:	SUITE J
City	:	MONROE
State	:	LA
Zip	:	71201-9207
Country	:	US
Telephone Number	:	318-387-1850
Fax Number	:	318-387-1864

Authorized Official
Title or Position	:	OWNER
Name	:	MS. MELANIE JANE AYCOCK
Credential	:	L.P.C.
Telephone Number	:	318-387-1850

Provider Enumeration Date	:	05/24/2007
Last Update Date	:	08/22/2020

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