Provider Demographics
NPI:1669751624
Name:ALLEN, GEORGE LEMEUL III (MA)
Entity type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:LEMEUL
Last Name:ALLEN
Suffix:III
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-6890
Mailing Address - Country:US
Mailing Address - Phone:318-448-0284
Mailing Address - Fax:318-448-0280
Practice Address - Street 1:1605 MURRAY ST
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-6890
Practice Address - Country:US
Practice Address - Phone:318-448-0284
Practice Address - Fax:318-448-0280
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist