Provider Demographics
NPI:1790269280
Name:GAUDET, BARBARA LYNN (LPC)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:LYNN
Last Name:GAUDET
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10670 FIRE TOWER RD
Mailing Address - Street 2:
Mailing Address - City:SAINT FRANCISVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70775-5404
Mailing Address - Country:US
Mailing Address - Phone:985-226-0428
Mailing Address - Fax:
Practice Address - Street 1:5689 A COMMERCE STREET
Practice Address - Street 2:
Practice Address - City:SAINT FRANCISVILLE
Practice Address - State:LA
Practice Address - Zip Code:70775-5404
Practice Address - Country:US
Practice Address - Phone:985-226-0428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3007101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19Medicaid