Provider Demographics
NPI:1679020903
Name:PICOU-BILLIOT, LACEY (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:LACEY
Middle Name:
Last Name:PICOU-BILLIOT
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1079
Mailing Address - Street 2:
Mailing Address - City:BOURG
Mailing Address - State:LA
Mailing Address - Zip Code:70343-1079
Mailing Address - Country:US
Mailing Address - Phone:985-232-0577
Mailing Address - Fax:
Practice Address - Street 1:1070 W TUNNEL BLVD STE 1
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4068
Practice Address - Country:US
Practice Address - Phone:985-232-0577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LALMFT LA-879106H00000X
LALPC LA-2801101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist