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NPI Code Detail

MEDICARE: DESIRE' NWEKE-ROBERSON LPC

MEDICARE: DESIRE' NWEKE-ROBERSON LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2171M00000XCase Manager/Care Coordinator
3101YP2500XProfessional Counselor8324LA

General Provider Information

NPI Number : 1104373026
Entity Type Code : Individual
Provider Name (Legal Business Name) : DESIRE' NWEKE-ROBERSON LPC
Provider Business Mailing Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number :
Provider Business Practice Location Address
First Line : 1925 ENTERPRISE BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-6371
Country : US
Telephone Number : 337-429-5129
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2016
Last Update Date : 08/04/2023

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Directions to “ DESIRE' NWEKE-ROBERSON LPC” Practice Location

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