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NPI Code Detail

MEDICARE: TAJAI MCCOLLUM

MEDICARE: TAJAI MCCOLLUM
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
1101YP2500XProfessional Counselor9104LA

General Provider Information

NPI Number : 1508546508
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAJAI MCCOLLUM
Provider Business Mailing Address
First Line : PO BOX 66558
Second Line :
City : BATON ROUGE
State : LA
Zip : 70896-6558
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2751 WOODDALE BLVD STE A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70805-7567
Country : US
Telephone Number : 225-925-1906
Fax Number : 225-362-5314
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2023
Last Update Date : 12/19/2025

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Directions to “ TAJAI MCCOLLUM ” Practice Location

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