Active NPI
Northlake Counseling and Consulting
- Professional Counselor
- Ponchatoula, LA
National Provider Identifier
1922369297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2753
- Legal business name
- NORTHLAKE COUNSELING AND CONSULTING
- Practice address
- 485 S 8TH St
Ponchatoula, LA 70454-3415 - Phone
- (985) 687-5226
- Fax
- (866) 657-7188
- NPI assigned
- Jun 4, 2012
- Last updated
- Jun 4, 2012
- 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
- Miss Jessica G Gandolfo, LPC, LMFT
- Title
- Owner
- Phone
- (985) 687-5226
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2753 | LA | Primary |
| Marriage & Family Therapist | 106H00000X | 1123 | LA |
Addresses
Primary practice location
485 S 8TH St
Ponchatoula, LA 70454-3415
Mailing address
902 C M Fagan Dr
Unit B
Hammond, LA 70403-6043
Phone (985) 687-5226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740457092 | Other | LA | INDIVIDUAL NPI |
National Provider Directory
National Provider Directory- Tax ID family
- Northlake Counseling and Consulting
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Community/Behavioral Health Agency
- Hammond, LA
- NPI 1275957979
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1338768000000",
"number": "1922369297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 C M FAGAN DR",
"address_2": "UNIT B",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704036043",
"telephone_number": "985-687-5226",
"fax_number": "866-657-7188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 S 8TH ST",
"city": "PONCHATOULA",
"state": "LA",
"postal_code": "704543415",
"telephone_number": "985-687-5226",
"fax_number": "866-657-7188"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NORTHLAKE COUNSELING AND CONSULTING",
"organizational_subpart": "NO",
"enumeration_date": "2012-06-04",
"last_updated": "2012-06-04",
"status": "A",
"authorized_official_last_name": "GANDOLFO",
"authorized_official_first_name": "JESSICA",
"authorized_official_middle_name": "G",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "985-687-5226",
"authorized_official_name_prefix": "Miss",
"authorized_official_credential": "LPC, LMFT"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "2753",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "1123",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "INDIVIDUAL NPI",
"identifier": "1740457092",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ponchatoula, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.