Provider Demographics
NPI:1508221979
Name:OUBRE, RENISHA CECILIA (MED, LPC-S, NCC)
Entity type:Individual
Prefix:MISS
First Name:RENISHA
Middle Name:CECILIA
Last Name:OUBRE
Suffix:
Gender:F
Credentials:MED, LPC-S, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 575
Mailing Address - Street 2:22795 HIGH RIDGE DRIVE
Mailing Address - City:VACHERIE
Mailing Address - State:LA
Mailing Address - Zip Code:70090-0575
Mailing Address - Country:US
Mailing Address - Phone:986-713-6353
Mailing Address - Fax:225-265-2170
Practice Address - Street 1:PO BOX 575
Practice Address - Street 2:22795 HIGH RIDGE DRIVE
Practice Address - City:VACHERIE
Practice Address - State:LA
Practice Address - Zip Code:70090-0575
Practice Address - Country:US
Practice Address - Phone:986-713-6353
Practice Address - Fax:225-265-2170
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-29
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX97422101YP2500X
FLTPMC3602101YP2500X
LALEVEL 3: 521315101YS0200X
171M00000X
LA5367101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
No171M00000XOther Service ProvidersCase Manager/Care Coordinator