Provider Demographics
NPI:1922497734
Name:THIBODEAUX, CHRISTINA SPEYRER (LPC, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:CHRISTINA
Middle Name:SPEYRER
Last Name:THIBODEAUX
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:MS
Other - First Name:CHRISTINA
Other - Middle Name:
Other - Last Name:SPEYRER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC-INTERN, LMFT-INT
Mailing Address - Street 1:110 SHERIDAN DR.
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506
Mailing Address - Country:US
Mailing Address - Phone:337-849-0019
Mailing Address - Fax:479-567-5661
Practice Address - Street 1:913 S. COLLEGE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503
Practice Address - Country:US
Practice Address - Phone:337-232-2833
Practice Address - Fax:337-234-4038
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-16
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1611170101YM0800X
VA0701006026101YM0800X
LA1150106H00000X
LA4540101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist