Doctor Name: | MR. RANDY FONTENOT |
NPI Number: | 1841528361 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LPC |
License Number: | 2810 |
Business Practice Address: | 5329 Dijon Drive Suite 105 Baton Rouge, LA - 70808 |
Business Phone Number: | 2252768428 |
Business Fax Number: | |
Mailing Address: | 5329 Dijon Drive, Suite 105 BATON ROUGE |
State: | LA |
Postal Code: | 708088721 |
Phone Number: | 2252768428 |
Fax Number: | |
NPI Enumeration Date: | 11/20/2009 |
NPI Last Update Date: | 06/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | 2810 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |