Provider Demographics
NPI:1649814328
Name:NORTHSHORE FAMILY RESOURCE CENTER LLC
Entity type:Organization
Organization Name:NORTHSHORE FAMILY RESOURCE CENTER LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CLAUDE
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:GUILLOTTE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC, LMFT
Authorized Official - Phone:985-892-5664
Mailing Address - Street 1:47142 OAK CREEK TRCE
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70401-3627
Mailing Address - Country:US
Mailing Address - Phone:985-892-5664
Mailing Address - Fax:985-892-5664
Practice Address - Street 1:100 S TYLER ST STE 7A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3050
Practice Address - Country:US
Practice Address - Phone:985-892-5664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-05
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty