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NPI Code Detail

MEDICARE: DR. DUDLEY G CHEWNING LMFT, LPC

MEDICARE:  DR. DUDLEY G CHEWNING  LMFT, 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
1101YP2500XProfessional Counselor1764LA
2106H00000XMarriage & Family Therapist334LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1334OTHERLALMFT
21764OTHERLALPC

General Provider Information

NPI Number : 1932177078
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DUDLEY G CHEWNING LMFT, LPC
Provider Business Mailing Address
First Line : 820 JORDAN ST
Second Line : SUITE 570
City : SHREVEPORT
State : LA
Zip : 71101-4518
Country : US
Telephone Number : 318-221-4455
Fax Number : 318-221-4459
Provider Business Practice Location Address
First Line : 820 JORDAN ST
Second Line : SUITE 570
City : SHREVEPORT
State : LA
Zip : 71101-4518
Country : US
Telephone Number : 318-221-4455
Fax Number : 318-221-4459
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2006
Last Update Date : 08/21/2007

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