Dildred Small Womack, LMFT, LPC-S
Individual provider Active NPI Counselor · Greensburg, LA
NPI 1215089990 · NPPES record last updated Feb 8, 2011
Key facts
- NPI
- 1215089990
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- TYPE A. 041732 & 266 (LA)
- Practice address
- 16120 Highway 10
Greensburg, LA 70441-3657 - Phone
- (225) 936-9248
- Fax
- (225) 222-3386
- NPI assigned
- Jan 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TYPE A. 041732 & 266 | LA | MD | Counselor |
| TYPE A. 041732 | LA | MD | School Counselor |
| 266 | LA | MD | Clinical Psychologist |
| 94 | LA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Counselor | Current | Accepting new patients |
| Wonderful Works | Current |
Accepting new patients |
Interoperability endpoints
- dildredwomack@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 94 | LA | |
| Professional Counselor | 101YP2500X | 266 | LA | |
| Mental Health Counselor | 101YM0800X | 266 | LA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 266 | LA | |
| School Counselor | 101YS0200X | TYPE A. 041732 | LA | |
| Counselor | 101Y00000X | TYPE A. 041732 & 266 | LA | Yes |
| Military Health Care Provider | 171000000X |
Addresses
Primary practice location
16120 Highway 10
Greensburg, LA 70441-3657
Mailing address
530 Small Road
Greensburg, LA 70441-3675
Phone (225) 936-9248
Other providers in Greensburg, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.