1285699975 NPI number — MS. AUDRA ELIZABETH DUHON M.ED, LPC, LMFT

Table of content: MS. AUDRA ELIZABETH DUHON M.ED, LPC, LMFT (NPI 1285699975)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285699975 NPI number — MS. AUDRA ELIZABETH DUHON M.ED, LPC, LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DUHON
Provider First Name:
AUDRA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.ED, LPC, LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUHON
Provider Other First Name:
AUDRA
Provider Other Middle Name:
STINSON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.ED, LPC, LMFT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1285699975
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6121 FERN AVE
Provider Second Line Business Mailing Address:
27
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71105-4151
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-797-6519
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 PIERREMONT RD
Provider Second Line Business Practice Location Address:
SUITE 251
Provider Business Practice Location Address City Name:
SHREVEPORT
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71106-2069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-869-4700
Provider Business Practice Location Address Fax Number:
318-869-4716
Provider Enumeration Date:
04/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  3116 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 436 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)





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