Provider Demographics
NPI:1730581489
Name:HICKORY COUNSELING
Entity type:Organization
Organization Name:HICKORY COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-309-7844
Mailing Address - Street 1:90 W IMPERIAL DR
Mailing Address - Street 2:
Mailing Address - City:HARAHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70123-4739
Mailing Address - Country:US
Mailing Address - Phone:504-615-4275
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:190 HICKORY AVE
Practice Address - Street 2:STE. 11
Practice Address - City:HARAHAN
Practice Address - State:LA
Practice Address - Zip Code:70123-4068
Practice Address - Country:US
Practice Address - Phone:504-615-4275
Practice Address - Fax:504-309-7845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC4499101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty