Active NPI
Nola Psychotherapy Center
- Professional Counselor
- Gretna, LA
National Provider Identifier
1073021663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- Legal business name
- NOLA PSYCHOTHERAPY CENTER
- Practice address
- 405 Gretna Boulevard
Suite 200
Gretna, LA 70053 - Phone
- (504) 500-7527
- NPI assigned
- Jan 17, 2018
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Gwyn Meredith, LPC-S
- Title
- Manager
- Phone
- (504) 267-0257
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | Primary | ||
| Professional Counselor | 101YP2500X | 3922 | LA |
Addresses
Primary practice location
405 Gretna Boulevard
Suite 200
Gretna, LA 70053
Mailing address
405 Gretna Blvd Ste 200
Gretna, LA 70053-4971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 600804356 | Medicaid | LA |
National Provider Directory
National Provider DirectoryLocations
405 Gretna Blvd
Ste 200
Gretna, LA 70053
Phone (504) 270-1723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516147200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1519084800000",
"number": "1073021663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 GRETNA BLVD STE 200",
"city": "GRETNA",
"state": "LA",
"postal_code": "700534971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 GRETNA BOULEVARD",
"address_2": "SUITE 200",
"city": "GRETNA",
"state": "LA",
"postal_code": "70053",
"telephone_number": "504-500-7527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NOLA PSYCHOTHERAPY CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2018-01-17",
"last_updated": "2018-02-20",
"status": "A",
"authorized_official_last_name": "MEREDITH",
"authorized_official_first_name": "GWYN",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "504-267-0257",
"authorized_official_credential": "LPC-S"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Professional",
"state": "LA",
"license": "3922",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "600804356",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Gretna, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.