Provider Demographics
NPI:1417761289
Name:SPRAGUE, MARGARET (MA; PLPC)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:SPRAGUE
Suffix:
Gender:
Credentials:MA; PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 TIGER DR
Mailing Address - Street 2:
Mailing Address - City:THIBODAUX
Mailing Address - State:LA
Mailing Address - Zip Code:70301-4337
Mailing Address - Country:US
Mailing Address - Phone:985-449-4055
Mailing Address - Fax:985-449-4178
Practice Address - Street 1:1418 TIGER DR
Practice Address - Street 2:
Practice Address - City:THIBODAUX
Practice Address - State:LA
Practice Address - Zip Code:70301-4337
Practice Address - Country:US
Practice Address - Phone:985-449-4055
Practice Address - Fax:985-449-4178
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC10579101YP2500X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No171M00000XOther Service ProvidersCase Manager/Care Coordinator