Provider Demographics
NPI:1013282037
Name:RODRIGUE, STEPHANIE W (LPC)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:W
Last Name:RODRIGUE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 BROADWAY AVE
Mailing Address - Street 2:BOX 503
Mailing Address - City:SCHRIEVER
Mailing Address - State:LA
Mailing Address - Zip Code:70395
Mailing Address - Country:US
Mailing Address - Phone:985-859-5956
Mailing Address - Fax:985-307-0190
Practice Address - Street 1:118 BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:SCHRIEVER
Practice Address - State:LA
Practice Address - Zip Code:70395
Practice Address - Country:US
Practice Address - Phone:985-859-5956
Practice Address - Fax:985-307-0190
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-09
Last Update Date:2012-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1811101YP2500X
LA1811-S101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional