Provider Demographics
NPI:1366724155
Name:ABBA COUNSELING CENTER
Entity type:Organization
Organization Name:ABBA COUNSELING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:318-371-9835
Mailing Address - Street 1:133 VALLEYVIEW ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-8979
Mailing Address - Country:US
Mailing Address - Phone:318-371-9835
Mailing Address - Fax:318-371-9835
Practice Address - Street 1:133 VALLEYVIEW ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-8979
Practice Address - Country:US
Practice Address - Phone:318-371-9835
Practice Address - Fax:318-371-9835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1585101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty