Provider Demographics
NPI:1417918723
Name:GANIER, PAUL J (LPC,PHD)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:J
Last Name:GANIER
Suffix:
Gender:M
Credentials:LPC,PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 ABBY RD
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-6020
Mailing Address - Country:US
Mailing Address - Phone:985-448-0764
Mailing Address - Fax:985-448-1912
Practice Address - Street 1:301 ABBY RD
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-6020
Practice Address - Country:US
Practice Address - Phone:985-448-0764
Practice Address - Fax:985-448-1912
Is Sole Proprietor?:No
Enumeration Date:2006-03-29
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALA1554101YM0800X
LA1554101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA821716761OtherTAX ID #