| Christina Thibodeaux, Lpc Ltd | |
|
1405 W Pinhook Rd Ste 108a Lafayette LA 70503-3100 | |
| (337) 849-0019 | |
| Not Available |
| Full Name | Christina Thibodeaux, Lpc Ltd |
|---|---|
| Speciality | Clinic/Center |
| Location | 1405 W Pinhook Rd Ste 108a, Lafayette, Louisiana |
| Authorized Official Name and Position | Christina Speyrer Thibodeaux (PRESIDENT) |
| Authorized Official Contact | 3378490019 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christina Thibodeaux, Lpc Ltd 110 Sheridan Dr Lafayette LA 70506-2610 Ph: (337) 501-4684 | Christina Thibodeaux, Lpc Ltd 1405 W Pinhook Rd Ste 108a Lafayette LA 70503-3100 Ph: (337) 849-0019 |
| NPI Number | 1366273385 |
|---|---|
| Provider Enumeration Date | 08/12/2024 |
| Last Update Date | 08/12/2024 |
| Certification Date | 08/12/2024 |
| Medicare PECOS PAC ID | 0941738355 |
|---|---|
| Medicare Enrollment ID | O20250114000257 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366273385 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
| Provider Name | Christina Speyrer Thibodeaux |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922497734 PECOS PAC ID: 6305374711 Enrollment ID: I20250114000332 |
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