Healthcare Provider Details

I. General information

NPI: 1528112570
Provider Name (Legal Business Name): GERALD DALE GARBER MS, LPC-S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 08/28/2024
Certification Date: 08/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

809 MARTIN LUTHER KING JR DR
LAFAYETTE LA
70501-1884
US

IV. Provider business mailing address

100 CORONA DR
LAFAYETTE LA
70503-4602
US

V. Phone/Fax

Practice location:
  • Phone: 337-704-0787
  • Fax: 337-233-7179
Mailing address:
  • Phone: 337-207-0482
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number881
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number881
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: