Individual provider Active NPI

Jessica Mae Dung

  • Counselor
  • Deridder, LA
National Provider Identifier
1811354590
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
115 Wilson St
Deridder, LA 70634-3823
Phone
(337) 463-4020
NPI assigned
Jan 26, 2016
Last updated
Jan 26, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

115 Wilson St
Deridder, LA 70634-3823

Mailing address

2525 Youree Dr Ste 110
Shreveport, LA 71104-3600
Phone (318) 742-3408

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1453766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453766400000",
    "number": "1811354590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 YOUREE DR STE 110",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711043600",
            "telephone_number": "318-742-3408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 WILSON ST",
            "city": "DERIDDER",
            "state": "LA",
            "postal_code": "706343823",
            "telephone_number": "337-463-4020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUNG",
        "first_name": "JESSICA",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-26",
        "last_updated": "2016-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deridder, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; 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.