Provider Demographics
NPI:1871355131
Name:GAUTREAUX, ANDREA K (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:K
Last Name:GAUTREAUX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70527-0309
Mailing Address - Country:US
Mailing Address - Phone:337-783-3171
Mailing Address - Fax:
Practice Address - Street 1:2122 N PARKERSON AVE STE A
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2001
Practice Address - Country:US
Practice Address - Phone:337-783-3171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA45881041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool