Fredrick Douglas Abraham II

Individual provider Active NPI Mental Health Counselor · Lake Charles, LA

NPI 1104339589 · NPPES record last updated Nov 8, 2017

Key facts

NPI
1104339589
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
1409 Kirkman St
Lake Charles, LA 70601-5344
Phone
(337) 419-3586
NPI assigned
Nov 8, 2017
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X Yes

Addresses

Primary practice location

1409 Kirkman St
Lake Charles, LA 70601-5344

Mailing address

1409 Kirkman St
Lake Charles, LA 70601-5344
Phone (337) 419-3586

Other providers in Lake Charles, LA

All providers in Lake Charles, LA · Mental Health Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.