Basic Information
| Provider Information | |||||||||
| NPI: | 1295176964 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | FIRM FOUNDATIONS FAMILY COUNSELING, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2905 EVANGELINE ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712013723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186547010 | ||||||||
| FaxNumber: | 3186547538 | ||||||||
| Practice Location | |||||||||
| Address1: | 2905 EVANGELINE ST | ||||||||
| Address2: | |||||||||
| City: | MONROE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 712013723 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186547010 | ||||||||
| FaxNumber: | 3186547538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2013 | ||||||||
| LastUpdateDate: | 10/10/2022 | ||||||||
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| AuthorizedOfficialLastName: | WHITE | ||||||||
| AuthorizedOfficialFirstName: | AMBER | ||||||||
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| AuthorizedOfficialTitleorPosition: | LICENSED PROFESSIONAL COUNSELOR | ||||||||
| AuthorizedOfficialTelephone: | 3186547010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MA, LPC-S | ||||||||
| NPICertificationDate: | 10/10/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | Y | 193400000X SINGLE SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.