Provider Demographics
NPI:1124463377
Name:HERNANDEZ, MICHELLE COMEAUX (LPC)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:COMEAUX
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 HARDING ST
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70503-2411
Mailing Address - Country:US
Mailing Address - Phone:337-501-7730
Mailing Address - Fax:337-235-6831
Practice Address - Street 1:1011 HARDING ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2411
Practice Address - Country:US
Practice Address - Phone:337-501-7730
Practice Address - Fax:337-235-6831
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-01
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA4937101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional