Provider Demographics
NPI:1841716982
Name:PITRE, LYNETTE DEBAILLON (LPC)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:DEBAILLON
Last Name:PITRE
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 1:1357 WILLOW COVE RD
Mailing Address - Street 2:
Mailing Address - City:CHURCH POINT
Mailing Address - State:LA
Mailing Address - Zip Code:70525-4742
Mailing Address - Country:US
Mailing Address - Phone:337-781-7219
Mailing Address - Fax:
Practice Address - Street 1:913 ALFRED ST
Practice Address - Street 2:
Practice Address - City:SCOTT
Practice Address - State:LA
Practice Address - Zip Code:70583-5117
Practice Address - Country:US
Practice Address - Phone:337-789-2264
Practice Address - Fax:337-504-2871
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-21
Last Update Date:2018-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional