Provider Demographics
NPI:1033495627
Name:GIRAUD, MAGGI JO (LMHP, LADC, LPC)
Entity Type:Individual
Prefix:MS
First Name:MAGGI
Middle Name:JO
Last Name:GIRAUD
Suffix:
Gender:F
Credentials:LMHP, LADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:137 BELFRY HWY
Mailing Address - Street 2:
Mailing Address - City:CODY
Mailing Address - State:WY
Mailing Address - Zip Code:82414-9524
Mailing Address - Country:US
Mailing Address - Phone:307-586-3725
Mailing Address - Fax:
Practice Address - Street 1:137 BELFRY HWY
Practice Address - Street 2:
Practice Address - City:CODY
Practice Address - State:WY
Practice Address - Zip Code:82414-9524
Practice Address - Country:US
Practice Address - Phone:307-586-3725
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE810101YA0400X
3909101YM0800X
NE1939101YP2500X
WYLAT348101YA0400X
WYLPC1399101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health