Provider Demographics
NPI:1467755124
Name:SAVANT, BENJAMIN TUCKER (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:TUCKER
Last Name:SAVANT
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:748 BAYOU PINES EAST DR STE D
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7595
Mailing Address - Country:US
Mailing Address - Phone:337-707-7724
Mailing Address - Fax:337-625-6968
Practice Address - Street 1:748 BAYOU PINES DRIVE EAST, STE. D
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601
Practice Address - Country:US
Practice Address - Phone:337-707-7724
Practice Address - Fax:337-419-0490
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-17
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3893101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health