Basic Information
| Provider Information | |||||||||
| NPI: | 1790230621 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LEGE | ||||||||
| FirstName: | TROY | ||||||||
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| Credential: | M.S., LPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4128 N UNIVERSITY AVE | ||||||||
| Address2: | |||||||||
| City: | CARENCRO | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705204206 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3372576073 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1325 WRIGHT AVE STE D | ||||||||
| Address2: | |||||||||
| City: | CROWLEY | ||||||||
| State: | LA | ||||||||
| PostalCode: | 705262226 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3375145181 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/21/2016 | ||||||||
| LastUpdateDate: | 07/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.