Provider Demographics
NPI:1083216980
Name:PEACE-BUIE, LINDA MARIE (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:PEACE-BUIE
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:PEACE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:PO BOX 74675
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70874-4675
Mailing Address - Country:US
Mailing Address - Phone:225-572-9622
Mailing Address - Fax:
Practice Address - Street 1:4811 HARDING BLVD.
Practice Address - Street 2:STE. 143
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70811
Practice Address - Country:US
Practice Address - Phone:225-572-9622
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-15
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA1536101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator