Provider Demographics
NPI:1063857191
Name:DAUGEREAU, ROBIN CLAIRE (MA, LPC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:CLAIRE
Last Name:DAUGEREAU
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70602-1273
Mailing Address - Country:US
Mailing Address - Phone:337-376-3013
Mailing Address - Fax:337-376-5244
Practice Address - Street 1:127 WILLIAMSBURG ST BLDG E
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5719
Practice Address - Country:US
Practice Address - Phone:337-376-0136
Practice Address - Fax:337-376-5244
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4894101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3057174Medicaid