Provider Demographics
NPI:1528872868
Name:ASEVEDO, CHRISTIAN SAGE (PLPC)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:SAGE
Last Name:ASEVEDO
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70056-7032
Mailing Address - Country:US
Mailing Address - Phone:504-392-0038
Mailing Address - Fax:
Practice Address - Street 1:1500 RIVER OAKS RD W
Practice Address - Street 2:
Practice Address - City:ELMWOOD
Practice Address - State:LA
Practice Address - Zip Code:70123-2163
Practice Address - Country:US
Practice Address - Phone:504-846-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-06
Last Update Date:2025-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC10480101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional