Provider Demographics
NPI:1144750159
Name:GATHANGA, LILIAN WANJIKU (MS LPC)
Entity Type:Individual
Prefix:MS
First Name:LILIAN
Middle Name:WANJIKU
Last Name:GATHANGA
Suffix:
Gender:F
Credentials:MS LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 COMMON ST APT 75
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-5752
Mailing Address - Country:US
Mailing Address - Phone:337-414-3397
Mailing Address - Fax:
Practice Address - Street 1:4510 COMMON ST APT 75
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-5752
Practice Address - Country:US
Practice Address - Phone:337-414-3397
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA8078101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor