MEDICARE: REYNELDA LASHAWN GIPSON-ARMSTRONG 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
1	101YM0800X	Mental Health Counselor
2	101YP2500X	Professional Counselor	4898	LA

General Provider Information

NPI Number	:	1174683064
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REYNELDA LASHAWN GIPSON-ARMSTRONG LPC

Provider Business Mailing Address
First Line	:	8676 GOODWOOD BLVD STE 105
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-7914
Country	:	US
Telephone Number	:	225-636-5817
Fax Number	:

Provider Business Practice Location Address
First Line	:	8676 GOODWOOD BLVD STE 105
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70806-7914
Country	:	US
Telephone Number	:	225-636-5817
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	05/17/2016

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