Healthcare Provider Details

I. General information

NPI: 1023659893
Provider Name (Legal Business Name): JOHN M DEAN LPC, LAC, NFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2019
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 PRIDE DR
HAMMOND LA
70401-9527
US

IV. Provider business mailing address

PO BOX 2799
COVINGTON LA
70434-2799
US

V. Phone/Fax

Practice location:
  • Phone: 985-543-4333
  • Fax: 985-543-4817
Mailing address:
  • Phone: 985-789-7444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1847
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: