Provider Demographics
NPI:1548505472
Name:LESTER, STEPHANIE BERGERON (MA, NCC, CIT, LPC-I)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:BERGERON
Last Name:LESTER
Suffix:
Gender:F
Credentials:MA, NCC, CIT, LPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2637 EDENBORN AVE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70002-7045
Mailing Address - Country:US
Mailing Address - Phone:504-455-2446
Mailing Address - Fax:
Practice Address - Street 1:2637 EDENBORN AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70002-7045
Practice Address - Country:US
Practice Address - Phone:504-455-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health