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NPI Code Detail

MEDICARE: NIALIFE CENTER FOR COUNSELING,LLC

MEDICARE: NIALIFE CENTER FOR COUNSELING,LLC
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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1548657562
Entity Type Code : Organization
Provider Name (Legal Business Name) : NIALIFE CENTER FOR COUNSELING,LLC
Provider Business Mailing Address
First Line : 14635 S HARRELLS FERRY RD STE 3A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-2960
Country : US
Telephone Number : 225-349-8984
Fax Number :
Provider Business Practice Location Address
First Line : 14635 S HARRELLS FERRY RD STE 3A
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-2960
Country : US
Telephone Number : 225-349-8984
Fax Number : 844-269-9818
Authorized Official
Title or Position : OWNER/EXECUTIVE DIRECTOR
Name : EBONY CARRIERE CHRISTOPHE
Credential : LPC-S
Telephone Number : 225-405-3821
Provider Enumeration Date : 04/16/2015
Last Update Date : 06/28/2023

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