Cynthia K. Duewall

Individual provider Active NPI Professional Counselor · Vidalia, LA

NPI 1801265012 · NPPES record last updated Mar 31, 2020

Key facts

NPI
1801265012
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
70638 (TX)
Practice address
1109 Carter St
Vidalia, LA 71373-3227
Phone
(318) 336-4700
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
70638TXMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 70638 TX Yes

Addresses

Primary practice location

1109 Carter St
Vidalia, LA 71373-3227

Mailing address

768 Highway 875
Wisner, LA 71378-4830
Phone (281) 814-4461

Other providers in Vidalia, LA

All providers in Vidalia, LA · Professional Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.