Provider Demographics
NPI:1023659893
Name:DEAN, JOHN M (LPC, LAC, NFA)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:M
Last Name:DEAN
Suffix:
Gender:M
Credentials:LPC, LAC, NFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2799
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:70434-2799
Mailing Address - Country:US
Mailing Address - Phone:985-789-7444
Mailing Address - Fax:
Practice Address - Street 1:100 S TYLER ST STE 7A
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3050
Practice Address - Country:US
Practice Address - Phone:985-789-7444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1847101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor