Provider Demographics
NPI:1619502358
Name:THOUIN, BRIDGET BERTRAND (LPC, NCC)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:BERTRAND
Last Name:THOUIN
Suffix:
Gender:F
Credentials:LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 LINE AVE STE 600
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4638
Mailing Address - Country:US
Mailing Address - Phone:318-425-3400
Mailing Address - Fax:
Practice Address - Street 1:1303 LINE AVE STE 600
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4638
Practice Address - Country:US
Practice Address - Phone:318-425-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-03
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8119101Y00000X
LA8119101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor