Provider Demographics
NPI:1861956385
Name:JAMES, CARMALISA WOLFE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CARMALISA
Middle Name:WOLFE
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 RUE PAON
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5154
Mailing Address - Country:US
Mailing Address - Phone:985-226-7252
Mailing Address - Fax:
Practice Address - Street 1:100 ASMA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3868
Practice Address - Country:US
Practice Address - Phone:337-456-7880
Practice Address - Fax:337-456-7882
Is Sole Proprietor?:No
Enumeration Date:2019-01-29
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3692101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health