Provider Demographics
NPI:1003409459
Name:LEJEUNE, JOHN BRYANT (LMSW)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:BRYANT
Last Name:LEJEUNE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 NILE ST
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-3910
Mailing Address - Country:US
Mailing Address - Phone:337-580-5002
Mailing Address - Fax:
Practice Address - Street 1:3455 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3764
Practice Address - Country:US
Practice Address - Phone:225-256-6604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-17
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA161511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical