Provider Demographics
NPI:1366594756
Name:NUGENT, BEVERLY L (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:L
Last Name:NUGENT
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4420 CONLIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006-2167
Mailing Address - Country:US
Mailing Address - Phone:504-885-0082
Mailing Address - Fax:504-885-0083
Practice Address - Street 1:4420 CONLIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-2167
Practice Address - Country:US
Practice Address - Phone:504-885-0082
Practice Address - Fax:504-885-0083
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA619101YM0800X
LA191106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist