Provider Demographics
NPI:1285282061
Name:VRANIC, AMY NICOLE (LPC)
Entity type:Individual
Prefix:MS
First Name:AMY
Middle Name:NICOLE
Last Name:VRANIC
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 REVERE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3168
Mailing Address - Country:US
Mailing Address - Phone:225-924-0123
Mailing Address - Fax:225-924-5455
Practice Address - Street 1:4727 REVERE AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3168
Practice Address - Country:US
Practice Address - Phone:225-924-0123
Practice Address - Fax:225-924-5455
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5655101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA14536331Medicaid