Corey Jack
Individual provider Active NPI Mental Health Counselor · Sunset, LA
NPI 1447703285 · NPPES record last updated Jul 28, 2016
Key facts
- NPI
- 1447703285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Practice address
- 311 Macarthur Dr
Sunset, LA 70584-6212 - Phone
- (337) 962-3737
- NPI assigned
- Jul 28, 2016
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Yes |
Addresses
Primary practice location
311 Macarthur Dr
Sunset, LA 70584-6212
Mailing address
311 Macarthur Dr
Sunset, LA 70584-6212
Phone (337) 962-3737
Other providers in Sunset, LA
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- Gwendyline Q Hall
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- Jeremy Dewayne Humphrey I
- Meagan Hurley
- Jessica Blanding Hooper MD a Professional Medical Corporation
- Brignette Lachelle Joseph
- Jeremy S Knott
- Scottie James Knott
- Gail G Leger
All providers in Sunset, LA · Mental Health Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 28, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.