Provider Demographics
NPI:1124520309
Name:AVERETTE, CEDRINA KNIGHT (PHD)
Entity type:Individual
Prefix:DR
First Name:CEDRINA
Middle Name:KNIGHT
Last Name:AVERETTE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 KALISTE SALOOM RD BLDG 1
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7449
Mailing Address - Country:US
Mailing Address - Phone:337-534-0727
Mailing Address - Fax:337-534-0737
Practice Address - Street 1:3312 KALISTE SALOOM RD BLDG 1
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7449
Practice Address - Country:US
Practice Address - Phone:337-534-0727
Practice Address - Fax:337-534-0737
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1397103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty