Provider Demographics
NPI:1144694811
Name:PERRON, ADRIAN MICHAEL (LAC #1297 LOUISIANA)
Entity type:Individual
Prefix:
First Name:ADRIAN
Middle Name:MICHAEL
Last Name:PERRON
Suffix:
Gender:M
Credentials:LAC #1297 LOUISIANA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BAY MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70507-2757
Mailing Address - Country:US
Mailing Address - Phone:337-344-0502
Mailing Address - Fax:
Practice Address - Street 1:210 BAY MEADOW LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70507-2757
Practice Address - Country:US
Practice Address - Phone:337-344-0502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-18
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1297101YA0400X, 101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health