Provider Demographics
NPI:1477106896
Name:BEGNAUD, JAMES LEO (LCDC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEO
Last Name:BEGNAUD
Suffix:
Gender:M
Credentials:LCDC
Other - Prefix:
Other - First Name:JIM
Other - Middle Name:
Other - Last Name:BEGNAUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCDC
Mailing Address - Street 1:2548 MEMORIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-2825
Mailing Address - Country:US
Mailing Address - Phone:409-983-1161
Mailing Address - Fax:409-209-0537
Practice Address - Street 1:103 W GIBSON ST STE 110
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951-4970
Practice Address - Country:US
Practice Address - Phone:409-489-9103
Practice Address - Fax:409-209-0537
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2019-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8637101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)