Provider Demographics
NPI:1457894362
Name:BILLEAUDEAU, PEGGY (LPC, LAC, CCS)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:
Last Name:BILLEAUDEAU
Suffix:
Gender:F
Credentials:LPC, LAC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8768 QUARTERS LAKE RD
Mailing Address - Street 2:BUILDING 11
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-2195
Mailing Address - Country:US
Mailing Address - Phone:225-343-4343
Mailing Address - Fax:
Practice Address - Street 1:8768 QUARTERS LAKE RD
Practice Address - Street 2:BUILDING 11
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-2195
Practice Address - Country:US
Practice Address - Phone:225-343-4343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-25
Last Update Date:2016-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1555101YA0400X
LA5804101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)