Provider Demographics
NPI:1700133253
Name:REAUX, JAMES E (LPC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:REAUX
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 BRUNDAGE LN
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5699
Mailing Address - Country:US
Mailing Address - Phone:337-335-7040
Mailing Address - Fax:
Practice Address - Street 1:106 BRUNDAGE LN
Practice Address - Street 2:
Practice Address - City:YOUNGSVILLE
Practice Address - State:LA
Practice Address - Zip Code:70592-5699
Practice Address - Country:US
Practice Address - Phone:337-335-7040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-14
Last Update Date:2012-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4757101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health