Provider Demographics
NPI:1043561913
Name:BLOUIN, LEE (LPC)
Entity Type:Individual
Prefix:
First Name:LEE
Middle Name:
Last Name:BLOUIN
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 1:7859 REILLY LN
Mailing Address - Street 2:
Mailing Address - City:ETHEL
Mailing Address - State:LA
Mailing Address - Zip Code:70730-3634
Mailing Address - Country:US
Mailing Address - Phone:225-719-0193
Mailing Address - Fax:
Practice Address - Street 1:54002 HIGHWAY 1062
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-3538
Practice Address - Country:US
Practice Address - Phone:985-606-9000
Practice Address - Fax:985-878-1900
Is Sole Proprietor?:No
Enumeration Date:2012-10-01
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA3873101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3873OtherLA STATE BOARD OF PROFESSIONAL COUNSELORS