Basic Information
| Provider Information | |||||||||
| NPI: | 1255758421 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINGLE | ||||||||
| FirstName: | NICHOLAS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3350 RIDGELAKE DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700023836 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048310446 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2000 OLD SPANISH TRL | ||||||||
| Address2: | #203 | ||||||||
| City: | SLIDELL | ||||||||
| State: | LA | ||||||||
| PostalCode: | 704588601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048310446 | ||||||||
| FaxNumber: | 9857814319 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2014 | ||||||||
| LastUpdateDate: | 03/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 2863 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 2863 | 01 | LA | 2863 LPC | OTHER |