Healthcare Provider Details

I. General information

NPI: 1659817245
Provider Name (Legal Business Name): ROXANNE PELTIER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2017
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 WILLIAMSBURG ST
LAKE CHARLES LA
70605-5720
US

IV. Provider business mailing address

184 WILLIAMSBURG ST
LAKE CHARLES LA
70605-5720
US

V. Phone/Fax

Practice location:
  • Phone: 337-437-4014
  • Fax: 337-437-8283
Mailing address:
  • Phone: 337-437-4014
  • Fax: 337-437-8283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: