Provider Demographics
NPI:1043543085
Name:BOUDREAUX, CARLA N (LPC-S)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:N
Last Name:BOUDREAUX
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:MISS
Other - First Name:CARLA
Other - Middle Name:R
Other - Last Name:NOBLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1615 JOHNSON ST STE C
Mailing Address - Street 2:
Mailing Address - City:JENNINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70546-3650
Mailing Address - Country:US
Mailing Address - Phone:337-616-0225
Mailing Address - Fax:337-616-0226
Practice Address - Street 1:1615 JOHNSON ST STE C
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-3650
Practice Address - Country:US
Practice Address - Phone:337-616-0225
Practice Address - Fax:337-616-0226
Is Sole Proprietor?:No
Enumeration Date:2009-09-09
Last Update Date:2016-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2659101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health