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Individual

COURTNEY HAWKINS MALVEAUX

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.A., LPC-S

Contact information

Practice address
4266 WEST MAIN ST. STE 100 ROOM 106, GRAY, LA 70359-6421
(504) 446-6410
Mailing address
107 CESARE DR, THIBODAUX, LA 70301-1102
(504) 255-7115

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6249
LA
101YP2500X
Professional Counselor
Primary
6249
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3122065
LA
Enumeration date
12/01/2015
Last updated
08/25/2021
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