Individual
BRENT SMITH NICOLINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LAC
Contact information
Practice address
4906 AMBASSADOR CAFFERY PKWY BLDG I, LAFAYETTE, LA 70508-7013
(337) 895-0300
(337) 218-7064
Mailing address
600 ST FRANCES STREET, LAFAYETTE, LA 70506
(337) 654-1988
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1650
LA
101YP2500X
Professional Counselor
Primary
9151
LA
Other
Enumeration date
08/04/2017
Last updated
12/12/2024
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