Provider Demographics
NPI:1942653712
Name:DEAL, JAWASKIE (LPC)
Entity Type:Individual
Prefix:
First Name:JAWASKIE
Middle Name:
Last Name:DEAL
Suffix:
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 1:315 S COLLEGE RD
Mailing Address - Street 2:100
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-3212
Mailing Address - Country:US
Mailing Address - Phone:337-205-6073
Mailing Address - Fax:
Practice Address - Street 1:203 W MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3795
Practice Address - Country:US
Practice Address - Phone:337-780-9855
Practice Address - Fax:337-234-3009
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA6936101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA6936OtherLPC LICENSE