Provider Demographics
NPI:1639805005
Name:DEGUEURCE, CHRISTOPHER CADE (PLPC)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:CADE
Last Name:DEGUEURCE
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3616 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2122
Mailing Address - Country:US
Mailing Address - Phone:318-779-0104
Mailing Address - Fax:318-421-3193
Practice Address - Street 1:2020 E 70TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5332
Practice Address - Country:US
Practice Address - Phone:318-751-9098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-28
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC9105101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health