Healthcare Provider Details

I. General information

NPI: 1265376800
Provider Name (Legal Business Name): HALEY MARGARET GAUTHIER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4066 RYAN ST
LAKE CHARLES LA
70605-2820
US

IV. Provider business mailing address

1505 HORSESHOE DR
COTTONPORT LA
71327-3542
US

V. Phone/Fax

Practice location:
  • Phone: 337-491-0800
  • Fax:
Mailing address:
  • Phone: 318-305-9377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9350
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: