Individual
JAWASKIE DEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
203 W MAIN ST STE 101, NEW IBERIA, LA 70560-3795
(337) 780-9855
(337) 234-3009
Mailing address
315 S COLLEGE RD, 100, LAFAYETTE, LA 70503-3212
(337) 205-6073
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6936
LA
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6936
LPC LICENSE
LA
Enumeration date
07/18/2016
Last updated
10/12/2021
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