Provider Demographics
NPI:1518307925
Name:RAYMOND, JENNIFER ELIZABETH NEAL (LPC-S)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:ELIZABETH NEAL
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 COTTAGE WAY
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-3950
Mailing Address - Country:US
Mailing Address - Phone:985-991-5377
Mailing Address - Fax:
Practice Address - Street 1:1198 BARROW ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-5693
Practice Address - Country:US
Practice Address - Phone:985-232-3930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-29
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3590101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional