| Northlake Counseling And Consulting | |
| 
					485 S 8th St Ponchatoula LA 70454-3415  | |
| (985) 687-5226 | |
| (866) 657-7188 | 
| Full Name | Northlake Counseling And Consulting | 
|---|---|
| Speciality | Counselor - Professional | 
| Location | 485 S 8th St, Ponchatoula, Louisiana | 
| Authorized Official Name and Position | Jessica G Gandolfo (OWNER) | 
| Authorized Official Contact | 9856875226 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Northlake Counseling And Consulting 902 C M Fagan Dr Unit B Hammond LA 70403-6043 Ph: (985) 687-5226  | Northlake Counseling And Consulting 485 S 8th St Ponchatoula LA 70454-3415 Ph: (985) 687-5226  | 
| NPI Number | 1922369297 | 
|---|---|
| Provider Enumeration Date | 06/04/2012 | 
| Last Update Date | 06/04/2012 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1922369297 | NPI | - | NPPES | 
| 1740457092 | Other | LA | INDIVIDUAL NPI | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | 1123 (Louisiana) | Secondary | 
| 101YP2500X | Counselor - Professional | 2753 (Louisiana) | Primary | 
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