Provider Demographics
NPI:1811201726
Name:HEBERT, DARYL (LPC,LAC,CRC,CCGC)
Entity Type:Individual
Prefix:MR
First Name:DARYL
Middle Name:
Last Name:HEBERT
Suffix:
Gender:M
Credentials:LPC,LAC,CRC,CCGC
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 513
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:LA
Mailing Address - Zip Code:70707-0513
Mailing Address - Country:US
Mailing Address - Phone:225-921-8855
Mailing Address - Fax:
Practice Address - Street 1:14635 S HARRELLS FERRY RD
Practice Address - Street 2:SUITE 6C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2959
Practice Address - Country:US
Practice Address - Phone:225-921-8855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA737101YA0400X
LA4224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)