Provider Demographics
NPI:1093144164
Name:CHAUVIN, IDA ANDING (LPC)
Entity type:Individual
Prefix:
First Name:IDA
Middle Name:ANDING
Last Name:CHAUVIN
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 1:243 HIGHWAY 3005
Mailing Address - Street 2:
Mailing Address - City:RUSTON
Mailing Address - State:LA
Mailing Address - Zip Code:71270-1074
Mailing Address - Country:US
Mailing Address - Phone:318-278-7610
Mailing Address - Fax:
Practice Address - Street 1:206 E REYNOLDS DR STE F2
Practice Address - Street 2:
Practice Address - City:RUSTON
Practice Address - State:LA
Practice Address - Zip Code:71270-2873
Practice Address - Country:US
Practice Address - Phone:318-224-7223
Practice Address - Fax:318-415-1004
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-08
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2401101YM0800X, 101YP2500X, 101Y00000X
LAMFT278106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist