Individual
JENISE NATE AYDELL-HONTIVEROS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
11990 JACKSON ST, CLINTON, LA 70722-3210
(225) 683-5292
(225) 683-1310
Mailing address
25623 MELANIE CIR, AMITE, LA 70422-5474
(855) 517-7089
(225) 529-9939
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
9861
LA
1041C0700X
Clinical Social Worker
Primary
9861
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2330152
—
LA
01
—
9861
SOCIAL WORK LICENSE NUMBER
LA
Enumeration date
06/17/2009
Last updated
12/03/2020
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