Provider Demographics
NPI:1407692726
Name:POCHE, BRENDA (LPC, NCC, CCTP)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:POCHE
Suffix:
Gender:F
Credentials:LPC, NCC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 ABACO LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-8154
Mailing Address - Country:US
Mailing Address - Phone:337-288-7784
Mailing Address - Fax:
Practice Address - Street 1:143 RIDGEWAY DR STE 106
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3410
Practice Address - Country:US
Practice Address - Phone:337-993-1960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8577101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health