Styron D Allen, DOCTOR OF THEOLOGY
Individual provider Active NPI Counselor · Lake Providence, LA
NPI 1992224034 · NPPES record last updated Sep 10, 2017
Key facts
- NPI
- 1992224034
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- Practice address
- 1700 Lake St # L
Lake Providence, LA 71254-5208 - Phone
- (318) 559-0551
- NPI assigned
- Sep 10, 2017
- Sex
- Male
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Marriage & Family Therapist | 106H00000X | |||
| Counselor | 101Y00000X | TN | Yes |
Addresses
Primary practice location
1700 Lake St # L
Lake Providence, LA 71254-5208
Mailing address
1513 Saint Louis Ave
Lake Providence, LA 71254-3637
Phone (318) 418-4376
Other providers in Lake Providence, LA
- A & L Medical Supplies, LLC
- At Home Adult Daycare
- Donovan Wilbur Bailey
- Cathy Ann Baker
- Tamika Baker
- Alisa Bell
All providers in Lake Providence, LA · Counselor in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2017. 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.