Active NPI
Grace Lucille Mamou, LPC
- Professional Counselor
- La Place, LA
National Provider Identifier
1447867189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7004
- Practice address
- 799 Fairway Dr
La Place, LA 70068-2007 - Phone
- (985) 652-0022
- NPI assigned
- Sep 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7004 | LA | Primary |
Addresses
Primary practice location
799 Fairway Dr
La Place, LA 70068-2007
Mailing address
PO Box 169
Garyville, LA 70051-0169
Phone (985) 233-9807
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | gmamou@ccano.org |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7004 | LA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1601164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601164800000",
"number": "1447867189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 169",
"city": "GARYVILLE",
"state": "LA",
"postal_code": "700510169",
"telephone_number": "985-233-9807"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "799 FAIRWAY DR",
"city": "LA PLACE",
"state": "LA",
"postal_code": "700682007",
"telephone_number": "985-652-0022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMOU",
"first_name": "GRACE",
"middle_name": "LUCILLE",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-27",
"last_updated": "2020-09-27",
"certification_date": "2020-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "7004",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "gmamou@ccano.org",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "799 Fairway Dr",
"city": "LA Place",
"state": "LA",
"country_code": "US",
"postal_code": "700682007",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in La Place, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.