Individual
JESSICA DOLORES GOODWILL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAC, NCC
Contact information
Practice address
3605 YOUREE DR, SHREVEPORT, LA 71105-2121
(318) 615-9006
Mailing address
3605 YOUREE DR, SHREVEPORT, LA 71105-2121
(318) 426-9656
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
PLC9375
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
CIT-5513
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
LAC-5163
LA
101YM0800X
Mental Health Counselor
Primary
PLC9375
LA
Other
Enumeration date
05/01/2023
Last updated
02/22/2025
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