Provider Demographics
NPI:1124566914
Name:BONNETTE, MELISSA DUPRE (LPC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:DUPRE
Last Name:BONNETTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:RENEE
Other - Last Name:DUPRE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:8727 ASPEN CT
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-6326
Mailing Address - Country:US
Mailing Address - Phone:985-518-8364
Mailing Address - Fax:
Practice Address - Street 1:11949 BRICKSOME AVE STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2595
Practice Address - Country:US
Practice Address - Phone:225-283-1175
Practice Address - Fax:225-666-0056
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-01
Last Update Date:2022-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4747101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional