# THEODORE R. LIAUTAUD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lakes Counseling & Psychiatry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487779575
- **Authorized official:** THEODORE R. LIAUTAUD DO (OWNER)
- **Authorized official phone:** (712) 657-2211

## Contact information

- **Practice address:** 421 E SHORE DR, LAKE VIEW, IA 51450
- **Practice address phone:** (712) 657-2211
- **Practice address fax:** (712) 657-2106
- **Mailing address:** PO BOX 710, 421 E SHORE DR, LAKE VIEW, IA 51450
- **Mailing address phone:** (712) 657-2211
- **Mailing address fax:** (712) 657-2106

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | 01790 | IA | Yes |
| 2084P0800X | Psychiatry Physician | 01790 | IA | — |

## Other

- **Enumeration date:** 03/20/2007
- **Last updated:** 09/30/2008