Provider Demographics
NPI:1447328695
Name:LANZILLOTTI, DAVID ANTHONY (MA LPC)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:ANTHONY
Last Name:LANZILLOTTI
Suffix:
Gender:M
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 DEVEREAUX DR
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-6128
Mailing Address - Country:US
Mailing Address - Phone:318-747-1171
Mailing Address - Fax:318-741-5128
Practice Address - Street 1:102 DEVEREAUX DR
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-6128
Practice Address - Country:US
Practice Address - Phone:318-747-1171
Practice Address - Fax:318-741-0522
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3223101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health