Provider Demographics
NPI:1154997781
Name:NOURISH COUNSELING STUDIO, LLC
Entity type:Organization
Organization Name:NOURISH COUNSELING STUDIO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:N
Authorized Official - Last Name:LONG
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:504-914-3067
Mailing Address - Street 1:110 BEAUREGARD LN S
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-3629
Mailing Address - Country:US
Mailing Address - Phone:504-914-3067
Mailing Address - Fax:
Practice Address - Street 1:3939 HOUMA BLVD UNIT 3A
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2931
Practice Address - Country:US
Practice Address - Phone:504-914-3067
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-03
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty