Individual
MR. BEAU MICHAELS LAVIOLETTE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LAC
Contact information
Practice address
11843 BRICKSOME AVE STE A, BATON ROUGE, LA 70816-5310
(504) 261-8654
Mailing address
13131 WOODRIDGE AVE, BATON ROUGE, LA 70809-5209
(504) 261-8654
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1401
LA
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
08/01/2016
Last updated
07/24/2019
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