Provider Demographics
NPI:1568653087
Name:DONNA AUCOIN, PH.D. & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DONNA AUCOIN, PH.D. & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:R
Authorized Official - Last Name:DEAVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:337-237-0788
Mailing Address - Street 1:5000 AMBASSADOR CAFFERY PKWY
Mailing Address - Street 2:BUILDING 13
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-6914
Mailing Address - Country:US
Mailing Address - Phone:337-237-0788
Mailing Address - Fax:337-237-0785
Practice Address - Street 1:5000 AMBASSADOR CAFFERY PKWY
Practice Address - Street 2:BUILDING 13
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-6914
Practice Address - Country:US
Practice Address - Phone:337-237-0788
Practice Address - Fax:337-237-0785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-08
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA880103T00000X
MS40-005103T00000X
LA846103T00000X
LA839103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty