Individual provider Active NPI

Logan White Tijerina, M.A., LPC

  • Professional Counselor
  • Lake Charles, LA
National Provider Identifier
1104793124
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8627 Issued in LA
Practice address
1541 Belfield Rd
Lake Charles, LA 70611-4715
Phone
(337) 427-8230
Fax
(337) 270-9427
NPI assigned
Oct 22, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 8627 LA Primary

Addresses

Primary practice location

1541 Belfield Rd
Lake Charles, LA 70611-4715

Mailing address

1541 Belfield Rd
Lake Charles, LA 70611-4715
Phone (337) 427-8230

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
8627LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Foundations Counseling & Wellness LLC CurrentSince Nov 7, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1761091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1104793124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 BELFIELD RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114715",
            "telephone_number": "337-427-8230",
            "fax_number": "337-270-9427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 BELFIELD RD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706114715",
            "telephone_number": "337-427-8230",
            "fax_number": "337-270-9427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIJERINA",
        "first_name": "LOGAN",
        "middle_name": "WHITE",
        "credential": "M.A., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-10-22",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "8627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.