Provider Demographics
NPI:1427587864
Name:LACHICA, JASON MICHEAL
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:MICHEAL
Last Name:LACHICA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3921 INDEPENDENCE DR STE 104
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-3566
Mailing Address - Country:US
Mailing Address - Phone:318-541-9334
Mailing Address - Fax:
Practice Address - Street 1:3921 INDPENDENCE DRIVE STE 104
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303
Practice Address - Country:US
Practice Address - Phone:318-541-9334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health