Healthcare Provider Details

I. General information

NPI: 1417090598
Provider Name (Legal Business Name): GENEVIA MARGARET ARSENE CRC, LPC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GENEVIA MARGARET ARSENE CRC, LPC

II. Dates (important events)

Enumeration Date: 02/15/2007
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1418 TIGER DR
THIBODAUX LA
70301-4337
US

IV. Provider business mailing address

1418 TIGER DR
THIBODAUX LA
70301-4337
US

V. Phone/Fax

Practice location:
  • Phone: 985-449-4055
  • Fax: 985-449-4178
Mailing address:
  • Phone: 985-449-4055
  • Fax: 985-449-4178

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4612
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: