Tristan Stewart, LPC
Individual provider Active NPI Professional Counselor · Prairieville, LA
NPI 1083470447 · NPPES record last updated May 30, 2025
Key facts
- NPI
- 1083470447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 9584 (LA)
- Practice address
- 17534 Old Jefferson Hwy Ste B2
Prairieville, LA 70769-3978 - Phone
- (225) 244-9110
- Fax
- (504) 335-0775
- NPI assigned
- Feb 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 22, 2026 through Apr 22, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9584 | LA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiffany Thibodeaux LLC | Professional | Current |
Accepting new patients |
Locations
1234 Del Este Ave
Ste 803
Denham Springs, LA 70726
Phone 2242449110 ext. 49110
17534 Old Jefferson Hwy
Ste B2
Prairieville, LA 70769
Phone (225) 244-9110
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 9584 | LA | Yes |
Addresses
Primary practice location
17534 Old Jefferson Hwy Ste B2
Prairieville, LA 70769-3978
Mailing address
17534 Old Jefferson Hwy Ste B2
Prairieville, LA 70769-3978
Phone (225) 244-9110
Other providers in Prairieville, LA
- St. Elizabeth Imaging LLC
- Stacy House Counseling
- Ronald Dewey Stailey
- Latawnya Stevenson-Evans
- Dedra Stevenson
- Kaelyn Storr
- Syntropy Wellness, LLC.
- Markia Lashae Tasker
- Trinity Tate
- Chrisline Tavernier
All providers in Prairieville, LA · Professional Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.