Healthcare Provider Details

I. General information

NPI: 1912461716
Provider Name (Legal Business Name): MELISSA C. STUTES-LACOUR LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA LACOUR LPC

II. Dates (important events)

Enumeration Date: 01/25/2019
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 RIDGEWAY DR STE 219
LAFAYETTE LA
70503-3410
US

IV. Provider business mailing address

105 MEADOW VIEW ST
MAURICE LA
70555-3267
US

V. Phone/Fax

Practice location:
  • Phone: 337-247-2043
  • Fax:
Mailing address:
  • Phone: 337-852-9353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number7708
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: