Provider Demographics
NPI:1164789947
Name:HIDALGO, DON (CEAP, LAC, SAP, CCGC)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:
Last Name:HIDALGO
Suffix:
Gender:M
Credentials:CEAP, LAC, SAP, CCGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4637 JAMESTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-3235
Mailing Address - Country:US
Mailing Address - Phone:225-927-0160
Mailing Address - Fax:225-924-0113
Practice Address - Street 1:4637 JAMESTOWN AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-3235
Practice Address - Country:US
Practice Address - Phone:225-927-0160
Practice Address - Fax:225-924-0113
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-18
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
LA1101YA0400X
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health