Provider Demographics
NPI:1922489418
Name:LAFITTE, MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:LAFITTE
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:PO BOX 44453
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71134-4453
Mailing Address - Country:US
Mailing Address - Phone:214-208-2230
Mailing Address - Fax:877-365-7926
Practice Address - Street 1:2940 LE OAKS DR
Practice Address - Street 2:1709
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-7821
Practice Address - Country:US
Practice Address - Phone:214-208-2230
Practice Address - Fax:877-365-7926
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5624101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional