Organization
NORTHLAKE COUNSELING AND CONSULTING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA GANDOLFO LPC-S, LMFT (OWNER)
(985) 687-5226
Entity
Organization
Contact information
Practice address
902 C M FAGAN DR STE B, HAMMOND, LA 70403-6043
(985) 687-5226
Mailing address
485 S 8TH ST, PONCHATOULA, LA 70454-3415
(985) 687-5226
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
2753
LA
Other
Enumeration date
02/17/2014
Last updated
02/17/2014
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