MEDICARE: MARY RETTA DRUMGOLD M.ED., LPC, NCC

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	9734	LA
2	171M00000X	Case Manager/Care Coordinator		LA
3	101YP2500X	Professional Counselor	9734	LA

General Provider Information

NPI Number	:	1962193664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY RETTA DRUMGOLD M.ED., LPC, NCC

Provider Business Mailing Address
First Line	:	9321 E CLAIBORNE PKWY
Second Line	:
City	:	BRIDGE CITY
State	:	LA
Zip	:	70094-3751
Country	:	US
Telephone Number	:	504-457-8051
Fax Number	:

Provider Business Practice Location Address
First Line	:	2016 TITAN ST
Second Line	:
City	:	HARVEY
State	:	LA
Zip	:	70058-2972
Country	:	US
Telephone Number	:	504-510-6808
Fax Number	:

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

Provider Enumeration Date	:	05/15/2023
Last Update Date	:	02/27/2026

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