Provider Demographics
NPI:1033695622
Name:O'HARA, SEAN WRIGHT (LPC)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:WRIGHT
Last Name:O'HARA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2119 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7863
Mailing Address - Country:US
Mailing Address - Phone:337-497-0034
Mailing Address - Fax:337-497-0229
Practice Address - Street 1:2119 OAK PARK BLVD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-497-0034
Practice Address - Fax:337-497-0229
Is Sole Proprietor?:No
Enumeration Date:2018-07-17
Last Update Date:2018-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC6834101Y00000X, 171M00000X
LA6834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171M00000XOther Service ProvidersCase Manager/Care Coordinator