Provider Demographics
NPI:1689162828
Name:CROCHET, BRIDGET LANDRY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRIDGET
Middle Name:LANDRY
Last Name:CROCHET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 HEYMANN BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2322
Mailing Address - Country:US
Mailing Address - Phone:337-504-4279
Mailing Address - Fax:
Practice Address - Street 1:1011 HARDING ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2411
Practice Address - Country:US
Practice Address - Phone:337-591-7563
Practice Address - Fax:337-247-9706
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-24
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA82701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical