Provider Demographics
NPI:1649074600
Name:DOUGAN, CIARA M (LBA)
Entity type:Individual
Prefix:
First Name:CIARA
Middle Name:M
Last Name:DOUGAN
Suffix:
Gender:
Credentials:LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 OAK PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7828
Mailing Address - Country:US
Mailing Address - Phone:337-429-5298
Mailing Address - Fax:337-656-2377
Practice Address - Street 1:430 ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:LA
Practice Address - Zip Code:70546-4442
Practice Address - Country:US
Practice Address - Phone:337-429-5298
Practice Address - Fax:337-656-2377
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst