Individual
REGINA MAILLOUX JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, LAC
Contact information
Practice address
400 MARINERS PLAZA DR STE 408F, MANDEVILLE, LA 70448-4797
(958) 718-4507
(504) 617-7878
Mailing address
400 MARINERS PLAZA DR STE 408F, MANDEVILLE, LA 70448-4797
(985) 464-9985
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1574
LA
101YM0800X
Mental Health Counselor
Primary
8517
LA
251S00000X
Community/Behavioral Health Agency
1574
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81-2765138
IRS
LA
Enumeration date
02/09/2017
Last updated
09/17/2025
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