Provider Demographics
NPI:1205219755
Name:PAPE, CRISTIE P (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:CRISTIE
Middle Name:P
Last Name:PAPE
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 RODERICK ST
Mailing Address - Street 2:
Mailing Address - City:MORGAN CITY
Mailing Address - State:LA
Mailing Address - Zip Code:70380-2277
Mailing Address - Country:US
Mailing Address - Phone:985-380-2455
Mailing Address - Fax:
Practice Address - Street 1:500 RODERICK ST
Practice Address - Street 2:
Practice Address - City:MORGAN CITY
Practice Address - State:LA
Practice Address - Zip Code:70380-2277
Practice Address - Country:US
Practice Address - Phone:985-380-2455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALPC 3249101YP2500X
LALMFT 1122106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist