Provider Demographics
NPI:1407656796
Name:CORMIER, PAULA ELIZABETH
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:ELIZABETH
Last Name:CORMIER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4906 AMBASSADOR CAFFERY PKWY BLDG I
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-7013
Mailing Address - Country:US
Mailing Address - Phone:337-895-0300
Mailing Address - Fax:337-210-7064
Practice Address - Street 1:4906 AMBASSADOR CAFFERY PKWY BLDG I
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-7013
Practice Address - Country:US
Practice Address - Phone:337-895-0300
Practice Address - Fax:337-210-7064
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-15
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1473101YA0400X
LA4433101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)