Mona M. Pellichino, LPC, LMFT
National Provider ID #1174810931
Tax ID #45-2707376
Licensed Professional Counselor
Licensed Marriage & Family Therapist
903 CM Fagan Drive
Hammond, LA 70403
Phone: (985) 956-7021
Fax: (985) 231-1277
Mona M. Pellichino, LPC, LMFT and its employees and volunteers collect data through a variety of means including but not necessarily limited to letters, phone calls, emails, voice mails, and from the submission of applications that is either required by law, or necessary to process applications or other requests for assistance through our organization.
Information about your financial situation and medical conditions and care that you provide to us in writing, via email, on the phone (including information left on voice mails), contained in or attached to applications, or directly or indirectly given to us, is held in strictest confidence.
We do not give out, exchange, barter, rent, sell, lend, or disseminate any information about applicants or clients who apply for or actually receive our services that is considered patient confidential, is restricted by law, or has been specifically restricted by a patient/client in a signed HIPAA consent form.
Information is only used as is reasonably necessary to process your application or to provide you with health or counseling services which may require communication between Mona M. Pellichino, LPC, LMFT and health care providers, medical product or service providers, pharmacies, insurance companies, and other providers necessary to: verify your medical information is accurate; determine the type of medical supplies or any health care services you need including, but not limited to; or to obtain or purchase any type of medical supplies, devices, medications, insurance,
If you apply or attempt to apply to receive assistance through us and provide information with the intent or purpose of fraud or that results in either an actual crime of fraud for any reason including willful or un-willful acts of negligence whether intended or not, or in any way demonstrates or indicates attempted fraud, your non-medical information can be given to legal authorities including police, investigators, courts, and/or attorneys or other legal professionals, as well as any other information as permitted by law.
Click to download HIPAA Notice of Privacy Practice.
Revision Date: September 8, 2016