Healthcare Provider Details

I. General information

NPI: 1316859564
Provider Name (Legal Business Name): RAE MARIE GUIDRY MS, PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 W PINHOOK RD STE 403
LAFAYETTE LA
70508-3212
US

IV. Provider business mailing address

154 QUEENSBERRY DR
LAFAYETTE LA
70508-5421
US

V. Phone/Fax

Practice location:
  • Phone: 337-354-9436
  • Fax:
Mailing address:
  • Phone: 409-988-8549
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLC10494
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: