Healthcare Provider Details

I. General information

NPI: 1982516647
Provider Name (Legal Business Name): MRS. LYNETTE MARIE DESDUNES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNETTE MARIE DUROUSSEAU

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 S HUNTINGTON ST
SULPHUR LA
70663-4837
US

IV. Provider business mailing address

1003 S HUNTINGTON ST
SULPHUR LA
70663-4837
US

V. Phone/Fax

Practice location:
  • Phone: 337-313-3108
  • Fax:
Mailing address:
  • Phone: 337-313-3108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPLM1639
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberPLM1639
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: