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General NPI Number Information
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NPI Number | 1083644645
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Entity Type | Individual
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Provider Name | ANDREW ANTHONY COMEAUX L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 2625 LINE AVE SUITE 106
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City | SHREVEPORT
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State | LA
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Zip | 71104-3047
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Country | US
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Telephone | 318-560-3458
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Fax | 318-554-0294
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Provider Business Mailing Address
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Address Line | 3602 GILBERT DR
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City | SHREVEPORT
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State | LA
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Zip | 71104-5002
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Country | US
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Telephone | 318-560-3458
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 0189
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4679
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License Number State | LA
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