Healthcare Provider Details

I. General information

NPI: 1700172764
Provider Name (Legal Business Name): ANASTASIA PORCHE ARCENEAUX LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/28/2011
Last Update Date: 05/20/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5599 HIGHWAY 311
HOUMA LA
70360-2866
US

IV. Provider business mailing address

137 SHARLENE ST
HOUMA LA
70364-1052
US

V. Phone/Fax

Practice location:
  • Phone: 985-857-3615
  • Fax: 985-857-3607
Mailing address:
  • Phone: 985-857-3615
  • Fax: 985-857-3607

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number4857
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: