Provider Demographics
NPI:1295796910
Name:EARLE, DAVID (LPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:EARLE
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7656 JEFFERSON HWY
Mailing Address - Street 2:SUITE: 1A
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-1101
Mailing Address - Country:US
Mailing Address - Phone:225-927-2455
Mailing Address - Fax:225-927-7921
Practice Address - Street 1:7656 JEFFERSON HWY
Practice Address - Street 2:SUITE: 1A
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-1101
Practice Address - Country:US
Practice Address - Phone:225-927-2455
Practice Address - Fax:225-927-7921
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1834101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional