Provider Demographics
NPI:1578629804
Name:GODEAUX, PAUL (MS,LPC,LMFT)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:
Last Name:GODEAUX
Suffix:
Gender:M
Credentials:MS,LPC,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 HODGES ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-4247
Mailing Address - Country:US
Mailing Address - Phone:337-433-4357
Mailing Address - Fax:337-433-9764
Practice Address - Street 1:833 HODGES ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-4247
Practice Address - Country:US
Practice Address - Phone:337-433-4357
Practice Address - Fax:337-433-9764
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1967101YM0800X, 101YP2500X
LA828106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist