Healthcare Provider Details

I. General information

NPI: 1194535773
Provider Name (Legal Business Name): CHRIST CENTERED COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W NORTHERN AVE
CROWLEY LA
70526-2639
US

IV. Provider business mailing address

416 KILCHRIST RD
CARENCRO LA
70520-5118
US

V. Phone/Fax

Practice location:
  • Phone: 337-900-8793
  • Fax:
Mailing address:
  • Phone: 337-900-8793
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: DANIEL L DUGAR
Title or Position: MANAGER
Credential:
Phone: 337-739-3452