MEDICARE: PERSEVERE COUNSELING AND CONSULTING,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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1659226850
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERSEVERE COUNSELING AND CONSULTING,LLC

Provider Business Mailing Address
First Line	:	2851 JOHNSTON ST
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-3243
Country	:	US
Telephone Number	:	337-255-0448
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 ASTER DR
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70506
Country	:	US
Telephone Number	:	337-255-0448
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	SHEMEKA FAULK
Credential	:	LPC
Telephone Number	:	337-255-0448

Provider Enumeration Date	:	03/03/2026
Last Update Date	:	03/03/2026

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