Provider Demographics
NPI:1982325585
Name:TRAHAN, DUSTIN JAMES (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:JAMES
Last Name:TRAHAN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4512 TOBY LN
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-7630
Mailing Address - Country:US
Mailing Address - Phone:985-212-2691
Mailing Address - Fax:
Practice Address - Street 1:3200 RIDGELAKE DR STE 100
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-4959
Practice Address - Country:US
Practice Address - Phone:504-581-4333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7481101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health