Provider Demographics
NPI:1962880666
Name:FOLARIN, COMFORT (LAC)
Entity type:Individual
Prefix:
First Name:COMFORT
Middle Name:
Last Name:FOLARIN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6210 LANDMARK DR
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-2339
Mailing Address - Country:US
Mailing Address - Phone:318-730-0418
Mailing Address - Fax:
Practice Address - Street 1:5615 JACKSON ST
Practice Address - Street 2:SUITE D
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2326
Practice Address - Country:US
Practice Address - Phone:318-442-9999
Practice Address - Fax:318-442-9976
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1529101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)