MEDICARE: NICOLE LYNN FREIRE

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	PLC9901	LA

General Provider Information

NPI Number	:	1740137355
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE LYNN FREIRE

Provider Business Mailing Address
First Line	:	1110 ERATO ST APT 2
Second Line	:
City	:	NEW ORLEANS
State	:	LA
Zip	:	70130-4205
Country	:	US
Telephone Number	:	504-701-6926
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 VETERANS BLVD STE 205A
Second Line	:
City	:	METAIRIE
State	:	LA
Zip	:	70005-4926
Country	:	US
Telephone Number	:	504-434-3577
Fax Number	:

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

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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