Provider Demographics
NPI:1699900282
Name:DUFRENE, AMY SIBLEY (LPC-S, NCC, BC-TMH)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:SIBLEY
Last Name:DUFRENE
Suffix:
Gender:F
Credentials:LPC-S, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 PARLIAMENT DR STE B
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71303-2720
Mailing Address - Country:US
Mailing Address - Phone:318-703-0431
Mailing Address - Fax:318-704-0433
Practice Address - Street 1:4207 PARLIAMENT DR STE B
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2720
Practice Address - Country:US
Practice Address - Phone:318-703-0431
Practice Address - Fax:318-704-0433
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-26
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3570955Medicaid