Provider Demographics
NPI:1134811748
Name:GEASON-HOLMES, CONSTANCE ANN (PSYD, LPCT)
Entity type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:ANN
Last Name:GEASON-HOLMES
Suffix:
Gender:F
Credentials:PSYD, LPCT
Other - Prefix:MS
Other - First Name:CONSTANCE
Other - Middle Name:ANN
Other - Last Name:GEASON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD, LPCT
Mailing Address - Street 1:58900 APRIL LANE
Mailing Address - Street 2:
Mailing Address - City:PLAQUEMINE
Mailing Address - State:LA
Mailing Address - Zip Code:70764
Mailing Address - Country:US
Mailing Address - Phone:225-776-4222
Mailing Address - Fax:
Practice Address - Street 1:58900 APRIL LANE
Practice Address - Street 2:
Practice Address - City:PLAQUEMINE
Practice Address - State:LA
Practice Address - Zip Code:70764
Practice Address - Country:US
Practice Address - Phone:225-776-4222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LACG229705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator