Provider Demographics
NPI:1952715831
Name:CORMIER, NINETTE (LPC)
Entity Type:Individual
Prefix:
First Name:NINETTE
Middle Name:
Last Name:CORMIER
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 1:206 KEES CIR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70506-2914
Mailing Address - Country:US
Mailing Address - Phone:337-280-2109
Mailing Address - Fax:
Practice Address - Street 1:329 S MAIN ST STE 1
Practice Address - Street 2:
Practice Address - City:OPELOUSAS
Practice Address - State:LA
Practice Address - Zip Code:70570-6137
Practice Address - Country:US
Practice Address - Phone:337-945-1032
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2923101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional