Provider Demographics
NPI:1821970211
Name:PERRIN, ERIC (CIT-5596)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:
Last Name:PERRIN
Suffix:
Gender:M
Credentials:CIT-5596
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GRANDLAKE DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5537
Mailing Address - Country:US
Mailing Address - Phone:337-400-1191
Mailing Address - Fax:
Practice Address - Street 1:306 OAK LANE DR
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4533
Practice Address - Country:US
Practice Address - Phone:337-400-1191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LACIT-5596101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)