Provider Demographics
NPI:1841430634
Name:LAWSON, CLARISSA (CFA)
Entity Type:Individual
Prefix:
First Name:CLARISSA
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:CFA
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 5923
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70302-5923
Mailing Address - Country:US
Mailing Address - Phone:985-859-4841
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:201 CEDAR ST
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70302
Practice Address - Country:US
Practice Address - Phone:985-859-4841
Practice Address - Fax:888-329-6432
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-06
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA246ZC0007X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant