Provider Demographics
NPI:1295023125
Name:MIGUEZ, SUMER LEDET (PHD MP)
Entity type:Individual
Prefix:MRS
First Name:SUMER
Middle Name:LEDET
Last Name:MIGUEZ
Suffix:
Gender:F
Credentials:PHD MP
Other - Prefix:MRS
Other - First Name:SUMER
Other - Middle Name:NOEL
Other - Last Name:LEDET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 795
Mailing Address - Street 2:
Mailing Address - City:LUTCHER
Mailing Address - State:LA
Mailing Address - Zip Code:70071-0795
Mailing Address - Country:US
Mailing Address - Phone:225-323-5087
Mailing Address - Fax:866-453-3775
Practice Address - Street 1:2232 SOUTH ALBERT STREET
Practice Address - Street 2:
Practice Address - City:LUTCHER
Practice Address - State:LA
Practice Address - Zip Code:70071-5245
Practice Address - Country:US
Practice Address - Phone:225-323-5087
Practice Address - Fax:866-453-3775
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1157103TC0700X
LA320660103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical