Provider Demographics
NPI:1003335001
Name:WESTPHAL, LUCAS ALEXANDER (LPC; NCC)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:ALEXANDER
Last Name:WESTPHAL
Suffix:
Gender:M
Credentials:LPC; NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20149 CLEMSON WAY
Mailing Address - Street 2:
Mailing Address - City:PONCHATOULA
Mailing Address - State:LA
Mailing Address - Zip Code:70454
Mailing Address - Country:US
Mailing Address - Phone:985-640-7711
Mailing Address - Fax:
Practice Address - Street 1:906 CM FAGAN DR.
Practice Address - Street 2:SUITE B3
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403
Practice Address - Country:US
Practice Address - Phone:985-640-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-12
Last Update Date:2017-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6349101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional