| Mrs La'quesha J Butler, LPC | |
|
1112 E Ascension Complex Blvd, Gonzales, LA 70737-4265 | |
| (225) 743-2445 | |
| (225) 450-1150 |
| Full Name | Mrs La'quesha J Butler |
|---|---|
| Gender | Female |
| Speciality | Counselor - Professional |
| Location | 1112 E Ascension Complex Blvd, Gonzales, Louisiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114391547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5568 (Louisiana) | Primary |
| Entity Name | Our Lady Of The Lake Physician Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1033494943 PECOS PAC ID: 4587849781 Enrollment ID: O20120529000377 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs La'quesha J Butler, LPC 5959 S Sherwood Forest Blvd, Baton Rouge, LA 70816-6038 Ph: (225) 743-2445 | Mrs La'quesha J Butler, LPC 1112 E Ascension Complex Blvd, Gonzales, LA 70737-4265 Ph: (225) 743-2445 |
Stacey G Moreau, M.ED., LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1112 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-621-5775 Fax: 225-644-2846 | |
Mrs. Laurice Derozan Harrison, DR. Counselor Medicare: Not Enrolled in Medicare Practice Location: 214 S. Burnside Ave, Ste 203, Gonzales, LA 70737 Phone: 225-647-9001 Fax: 225-647-9001 | |
Lance Joseph Miguez, LPC Counselor Medicare: Accepting Medicare Assignments Practice Location: 12320 Highway 44 Ste 3d, Gonzales, LA 70737 Phone: 225-253-3357 | |
Alexis Ray Russell, Counselor Medicare: Not Enrolled in Medicare Practice Location: 14430 Caribbean Dr, Gonzales, LA 70737 Phone: 225-993-6861 | |
Candace Sharper, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1058 E Worthy St, Gonzales, LA 70737 Phone: 225-258-7322 Fax: 225-450-3799 | |
Lisa Schuster, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1112 E Ascension Complex Blvd, Gonzales, LA 70737 Phone: 225-450-1016 |