| Big Easy Therapy | |
|
1799 Stumpf Blvd Building 2, Suite 5 Terrytown LA 70056 | |
| (504) 233-2295 | |
| (504) 910-0651 |
| Full Name | Big Easy Therapy |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 1799 Stumpf Blvd, Terrytown, Louisiana |
| Authorized Official Name and Position | Nikole L Dominique-maikell (OWNER/THERAPIST) |
| Authorized Official Contact | 5042332295 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Big Easy Therapy 1799 Stumpf Blvd Building 2, Suite 5 Terrytown LA 70056 Ph: (504) 233-2295 | Big Easy Therapy 1799 Stumpf Blvd Building 2, Suite 5 Terrytown LA 70056 Ph: (504) 233-2295 |
| NPI Number | 1710632419 |
|---|---|
| Provider Enumeration Date | 02/21/2022 |
| Last Update Date | 05/24/2022 |
| Certification Date | 05/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710632419 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | () | Primary |
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