Provider Demographics
NPI:1013160928
Name:PHINNEY, LARRY C (LPC)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:C
Last Name:PHINNEY
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 1:30270 JERICHO DR
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:LA
Mailing Address - Zip Code:70711-2818
Mailing Address - Country:US
Mailing Address - Phone:225-567-2928
Mailing Address - Fax:225-294-0404
Practice Address - Street 1:40521 PUMPKIN CENTER RD
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1835
Practice Address - Country:US
Practice Address - Phone:985-320-0237
Practice Address - Fax:225-294-0404
Is Sole Proprietor?:No
Enumeration Date:2008-10-23
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional