Provider Demographics
NPI:1679891022
Name:KEVIN J. TRIPEAUX, LCSW-BACS & ASSOCIATES
Entity Type:Organization
Organization Name:KEVIN J. TRIPEAUX, LCSW-BACS & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIPEAUX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-BACS
Authorized Official - Phone:225-439-2137
Mailing Address - Street 1:5225 CAPITOL HEIGHTS AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6066
Mailing Address - Country:US
Mailing Address - Phone:225-439-2137
Mailing Address - Fax:225-927-4598
Practice Address - Street 1:5225 CAPITOL HEIGHTS AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6066
Practice Address - Country:US
Practice Address - Phone:225-439-2137
Practice Address - Fax:225-927-4598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-10
Last Update Date:2010-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA52421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty