Healthcare Provider Details

I. General information

NPI: 1699832931
Provider Name (Legal Business Name): DAVID O. C. ADKINS LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 12/29/2021
Certification Date: 12/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 NW RAILROAD AVE STE 308
HAMMOND LA
70401-3278
US

IV. Provider business mailing address

201 NW RAILROAD AVE STE 308
HAMMOND LA
70401-3278
US

V. Phone/Fax

Practice location:
  • Phone: 985-345-8363
  • Fax: 985-662-3944
Mailing address:
  • Phone: 985-345-8363
  • Fax: 985-662-3944

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number113
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number653
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: