Provider Demographics
NPI:1568424331
Name:GAY, LOUISE (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:
Last Name:GAY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 HUFFINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-2721
Mailing Address - Country:US
Mailing Address - Phone:904-725-6463
Mailing Address - Fax:904-724-5006
Practice Address - Street 1:1545 HUFFINGHAM RD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-2721
Practice Address - Country:US
Practice Address - Phone:904-725-6463
Practice Address - Fax:904-724-5006
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1491101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMT1491OtherLICENSED MARRIAGE & FAMIL