Healthcare Provider Details

I. General information

NPI: 1720677669
Provider Name (Legal Business Name): TRAHAN MENTAL HEALTH SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/14/2021
Last Update Date: 01/14/2021
Certification Date: 01/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HARDING ST
LAFAYETTE LA
70503-2411
US

IV. Provider business mailing address

108 REBECCA DR
LAFAYETTE LA
70508-5966
US

V. Phone/Fax

Practice location:
  • Phone: 337-247-7272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SARA TRAHAN
Title or Position: COUNSELOR/OWNER
Credential: LPC
Phone: 337-247-7272