Provider Demographics
NPI:1851753644
Name:TAFFARO, CRAIG JR (LPC)
Entity Type:Individual
Prefix:MR
First Name:CRAIG
Middle Name:
Last Name:TAFFARO
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3225 COULON DR
Mailing Address - Street 2:
Mailing Address - City:MERAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70075-2594
Mailing Address - Country:US
Mailing Address - Phone:504-401-3654
Mailing Address - Fax:
Practice Address - Street 1:3225 COULON DR
Practice Address - Street 2:
Practice Address - City:MERAUX
Practice Address - State:LA
Practice Address - Zip Code:70075-2594
Practice Address - Country:US
Practice Address - Phone:504-401-3654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2016-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6338101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional