Provider Demographics
NPI:1619335981
Name:BRASHEAR, PARIS
Entity Type:Individual
Prefix:
First Name:PARIS
Middle Name:
Last Name:BRASHEAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 MAGNOLIA ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-6304
Mailing Address - Country:US
Mailing Address - Phone:985-879-3966
Mailing Address - Fax:
Practice Address - Street 1:1408 W WILLOW ST APT 201
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70506-1030
Practice Address - Country:US
Practice Address - Phone:985-498-6787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-02
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health