Provider Demographics
NPI:1487118154
Name:DOUCET, DAPEGE (MSW, MHP)
Entity type:Individual
Prefix:
First Name:DAPEGE
Middle Name:
Last Name:DOUCET
Suffix:
Gender:F
Credentials:MSW, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1799 STUMPF BLVD.
Mailing Address - Street 2:BUILDING 3 SUITE 4
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70053
Mailing Address - Country:US
Mailing Address - Phone:985-297-3226
Mailing Address - Fax:
Practice Address - Street 1:1799 STUMPF BLVD.
Practice Address - Street 2:BUILDING 3 SUITE 4
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053
Practice Address - Country:US
Practice Address - Phone:985-297-3226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9310101YM0800X, 171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health