Provider Demographics
NPI:1770051005
Name:PREJEAN, KERRI (EDD, LPC-S, RPT)
Entity type:Individual
Prefix:
First Name:KERRI
Middle Name:
Last Name:PREJEAN
Suffix:
Gender:F
Credentials:EDD, LPC-S, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2309 GRAND POINT RD
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-3323
Mailing Address - Country:US
Mailing Address - Phone:337-935-2310
Mailing Address - Fax:
Practice Address - Street 1:2309 GRAND POINT RD
Practice Address - Street 2:
Practice Address - City:BREAUX BRIDGE
Practice Address - State:LA
Practice Address - Zip Code:70517-3323
Practice Address - Country:US
Practice Address - Phone:337-935-2310
Practice Address - Fax:337-395-3940
Is Sole Proprietor?:No
Enumeration Date:2018-11-05
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4460101YP2500X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional