Provider Demographics
NPI:1447313960
Name:HESLET, LYNETTE (PHD)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:HESLET
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 GAUSE BLVD STE 304
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-2854
Mailing Address - Country:US
Mailing Address - Phone:198-544-5144
Mailing Address - Fax:504-896-7273
Practice Address - Street 1:700 GAUSE BLVD STE 304
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-2854
Practice Address - Country:US
Practice Address - Phone:985-445-1444
Practice Address - Fax:985-445-1285
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2021-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMPAP.000021103T00000X
LAMP1049103T00000X
MS47826103TC0700X
103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1035203Medicaid