Cindy L Willis, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4108 Issued in LA

Practice address

2920 Knight St Ste 112
Shreveport, LA 71105

Phone

(318) 510-0612

NPI assigned

May 6, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CLW Counseling, LLC

  • Professional Counselor
  • Shreveport, LA
  • NPI 1013493873
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531440000000",
    "number": "1720423593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 CATTAIL TRL",
            "city": "BENTON",
            "state": "LA",
            "postal_code": "710069719",
            "telephone_number": "318-510-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 KNIGHT ST STE 112",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71105",
            "telephone_number": "318-510-0612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "CINDY",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2018-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "4108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willis-Knighton Medical System
• Brandy Willis
• Brian Keith Willis, M.D.
• Cedric R Willis, PA-C
• Chase Kylen Willis
• Darien Willis
• Diamond Marie Willis
• Elizabeth Reaves Willis, NP
• Fred S Willis, MD
• Fred Spencer Willis Sr., M.D.

• Professional Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.