Provider Demographics
NPI:1447817614
Name:ETIENNE, D'SHAWN PAUL (LPC, PLMFT)
Entity type:Individual
Prefix:
First Name:D'SHAWN
Middle Name:PAUL
Last Name:ETIENNE
Suffix:
Gender:M
Credentials:LPC, PLMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 N 6TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-4119
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:403 N 6TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:WEST MONROE
Practice Address - State:LA
Practice Address - Zip Code:71291
Practice Address - Country:US
Practice Address - Phone:318-737-7201
Practice Address - Fax:318-737-7693
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-23
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1387106H00000X
171M00000X
LA7908101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator