Denise Amie Thibodeaux, M.ED., NCC, LPC, LAC

Individual provider Active NPI Professional Counselor · Sorrento, LA

NPI 1013274901 · NPPES record last updated Sep 16, 2022

Key facts

NPI
1013274901
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
LPC 4943 (LA)
Practice address
7384 John Leblanc Blvd
Sorrento, LA 70778-3231
Phone
(225) 300-4850
NPI assigned
Apr 16, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
LPC 4943LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
The Grove of la, LLC Current Accepting new patients
The Grove of la, LLC Professional Current Accepting new patients

Locations

2645 Oneal Ln
Bldg C-C
Baton Rouge, LA 70816
Phone (225) 326-4637

5311 Dijon Dr
Baton Rouge, LA 70808
Phone (225) 300-4850

7384 John Leblanc Blvd
Sorrento, LA 70778
Phone (225) 300-4850

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC 4943 LA
Professional Counselor 101YP2500X LPC 4943 LA Yes

Addresses

Primary practice location

7384 John Leblanc Blvd
Sorrento, LA 70778-3231

Mailing address

7384 John Leblanc Blvd
Sorrento, LA 70778-3231
Phone (225) 330-9328

Other practice location 1

5311 Dijon Dr
Baton Rouge, LA 70808-4314
Phone (225) 300-4850

Other providers in Sorrento, LA

All providers in Sorrento, LA · Professional Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.