Provider Demographics
NPI:1548436843
Name:FEGAN, DENYSE E (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:DENYSE
Middle Name:E
Last Name:FEGAN
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:MANDEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70470-0550
Mailing Address - Country:US
Mailing Address - Phone:985-778-3424
Mailing Address - Fax:
Practice Address - Street 1:312 S JEFFERSON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:COVINGTON
Practice Address - State:LA
Practice Address - Zip Code:70433-3169
Practice Address - Country:US
Practice Address - Phone:985-778-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-06
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3194101YP2500X
LA1028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist