Provider Demographics
NPI:1649742768
Name:EGUAKUN, GIANNI (LPC-ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:GIANNI
Middle Name:
Last Name:EGUAKUN
Suffix:
Gender:F
Credentials:LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3618 WINGATE PARK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-9001
Mailing Address - Country:US
Mailing Address - Phone:346-432-1648
Mailing Address - Fax:
Practice Address - Street 1:105 INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-3207
Practice Address - Country:US
Practice Address - Phone:337-534-0254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-31
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX90638101YM0800X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator