Provider Demographics
NPI:1538641253
Name:GUILBEAU, CANDICE (MS, LPC, RPT)
Entity Type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:GUILBEAU
Suffix:
Gender:F
Credentials:MS, LPC, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 COVENTRY ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-6182
Mailing Address - Country:US
Mailing Address - Phone:337-315-9683
Mailing Address - Fax:
Practice Address - Street 1:312 GUILBEAU RD STE 5C
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-6954
Practice Address - Country:US
Practice Address - Phone:330-967-0506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6796101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health