Provider Demographics
NPI:1124164512
Name:DEASON, LOY LAMAR (LPC)
Entity type:Individual
Prefix:MR
First Name:LOY
Middle Name:LAMAR
Last Name:DEASON
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 N DREW ST
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-3111
Mailing Address - Country:US
Mailing Address - Phone:936-327-3914
Mailing Address - Fax:
Practice Address - Street 1:235 S MARSH DR
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-3120
Practice Address - Country:US
Practice Address - Phone:936-327-3914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLPC 14025101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional