Provider Demographics
NPI:1538871249
Name:JOLIVETTE AFFIRMATIVE COUNSELING LLC
Entity type:Organization
Organization Name:JOLIVETTE AFFIRMATIVE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, LPC
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:JOLIVETTE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC, NCC
Authorized Official - Phone:337-205-3160
Mailing Address - Street 1:114 NICKERSON PKWY
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70501-6510
Mailing Address - Country:US
Mailing Address - Phone:337-205-3160
Mailing Address - Fax:
Practice Address - Street 1:114 NICKERSON PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70501-6510
Practice Address - Country:US
Practice Address - Phone:337-205-3160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-14
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty