Basic Information
| Provider Information | |||||||||
| NPI: | 1528278082 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SERGEANT | ||||||||
| FirstName: | CARRA | ||||||||
| MiddleName: | SUSAN | ||||||||
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| Credential: | LPC, NBCC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 137 TURPS RD | ||||||||
| Address2: | |||||||||
| City: | RAGLEY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 706577208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375805433 | ||||||||
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| Practice Location | |||||||||
| Address1: | 130 S 3RD ST | ||||||||
| Address2: | |||||||||
| City: | EUNICE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705354614 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3374573000 | ||||||||
| FaxNumber: | 3374573055 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 1706 | LA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.