MEDICARE: RAECHELLE NYE ALFRED

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	PLC11234	LA

General Provider Information

NPI Number	:	1407787948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAECHELLE NYE ALFRED

Provider Business Mailing Address
First Line	:	408 WEAVER WAY
Second Line	:
City	:	MAURICE
State	:	LA
Zip	:	70555-3481
Country	:	US
Telephone Number	:	504-487-0564
Fax Number	:

Provider Business Practice Location Address
First Line	:	708 W UNIVERSITY AVE STE 200
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506-3500
Country	:	US
Telephone Number	:	337-781-9742
Fax Number	:

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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Directions to “ RAECHELLE NYE ALFRED ” Practice Location

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