Provider Demographics
NPI:1871181859
Name:DUPRE, TIFFANY A (MA, LPC)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:A
Last Name:DUPRE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1619 SAMPSON ST STE B
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:LA
Mailing Address - Zip Code:70669-4013
Mailing Address - Country:US
Mailing Address - Phone:337-915-0132
Mailing Address - Fax:
Practice Address - Street 1:1619 SAMPSON ST STE B
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:LA
Practice Address - Zip Code:70669-4013
Practice Address - Country:US
Practice Address - Phone:337-915-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-06
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7929101YP2500X
LAPLC7929101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional