Provider Demographics
NPI:1740658616
Name:DOHERTY, ERIN (LPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:DOHERTY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SAINT TAMMANY ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6064
Mailing Address - Country:US
Mailing Address - Phone:225-929-9738
Mailing Address - Fax:
Practice Address - Street 1:555 SAINT TAMMANY ST
Practice Address - Street 2:SUITE D
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-6064
Practice Address - Country:US
Practice Address - Phone:225-929-9738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-09
Last Update Date:2015-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5237101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional