Provider Demographics
NPI:1972999118
Name:LANDRY, JULIET JONES (LPC, RN)
Entity Type:Individual
Prefix:
First Name:JULIET
Middle Name:JONES
Last Name:LANDRY
Suffix:
Gender:F
Credentials:LPC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 SAINT MARY ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-2634
Mailing Address - Country:US
Mailing Address - Phone:985-438-1177
Mailing Address - Fax:
Practice Address - Street 1:201 W 7TH ST
Practice Address - Street 2:SUITE #7
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-3250
Practice Address - Country:US
Practice Address - Phone:985-438-1177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-14
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA376-2101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional