Provider Demographics
NPI:1871343855
Name:LASALLE, JESSI L (MS, LPC)
Entity type:Individual
Prefix:MRS
First Name:JESSI
Middle Name:L
Last Name:LASALLE
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:113 CEZANNE DR
Mailing Address - Street 2:
Mailing Address - City:RAYNE
Mailing Address - State:LA
Mailing Address - Zip Code:70578-2744
Mailing Address - Country:US
Mailing Address - Phone:337-342-5850
Mailing Address - Fax:
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY BLDG I
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7013
Practice Address - Country:US
Practice Address - Phone:337-349-5431
Practice Address - Fax:337-210-7064
Is Sole Proprietor?:No
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA8895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health