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Jerome Wilson
Professional Counselor in Thibodaux, Louisiana
NPI 1922648674

Jerome Wilson is a Professional Counselor based in Thibodaux, LA and is specialized in Professional. Jerome Wilson practices in Thibodaux, LA. The NPI Number for Jerome Wilson is 1922648674 and holds a License No. 38-3949990 (Louisiana).

The current practice location address for Jerome Wilson is 100 Diplomat Way, Thibodaux, LA and can be reached out via phone at 985-316-6483. You can also correspond with Jerome Wilson through the mailing address at 100 DIPLOMAT WAY, THIBODAUX, LA - 70301-4314 (mailing address contact number: 985-316-6483).

Location: 100 Diplomat Way, Thibodaux, LA, 70301-4314
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1922648674
Provider Name
Jerome Wilson
Credential
Provider Entity Type
Individual
Gender
Male
Address
100 Diplomat Way, Thibodaux, LA, 70301-4314
Phone Number
985-316-6483
Fax Number
Provider Enumeration Date
01/10/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
NA 05 LA
institution
Provider Business Practice Location Address Details
Address
100 Diplomat Way
City
Thibodaux
State
Louisiana
Zip
70301-4314
Phone Number
985-316-6483
Fax Number
person
Provider Business Mailing Address Details
Address
100 Diplomat Way
City
Thibodaux
State
Louisiana
Zip
70301-4314
Phone Number
985-316-6483
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
(Louisiana)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Psychologist
Speciality
Family
Taxonomy
103TF0000X
License No.
38-3949990 (Louisiana)
Definition
A psychologist whose specialty is founded on principles of systems theory with the interpersonal system of the family the focus of assessment, intervention and research.
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