Provider Demographics
NPI:1952830390
Name:JUAREZ, ELICIA CLAIRE (LPC, PLMFT)
Entity Type:Individual
Prefix:
First Name:ELICIA
Middle Name:CLAIRE
Last Name:JUAREZ
Suffix:
Gender:F
Credentials:LPC, PLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2541 VULCAN ST
Mailing Address - Street 2:
Mailing Address - City:HARVEY
Mailing Address - State:LA
Mailing Address - Zip Code:70058-6106
Mailing Address - Country:US
Mailing Address - Phone:504-606-1216
Mailing Address - Fax:
Practice Address - Street 1:2541 VULCAN ST
Practice Address - Street 2:
Practice Address - City:HARVEY
Practice Address - State:LA
Practice Address - Zip Code:70058-6106
Practice Address - Country:US
Practice Address - Phone:504-606-1216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health