Healthcare Provider Details

I. General information

NPI: 1780740001
Provider Name (Legal Business Name): CYNTHIA B. SHREWSBERRY, MA,LPC, LMFT, NCC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 STATE ST
LAKE CHARLES LA
70605-5718
US

IV. Provider business mailing address

PO BOX 7452
LAKE CHARLES LA
70606-7452
US

V. Phone/Fax

Practice location:
  • Phone: 337-478-1616
  • Fax: 337-478-1632
Mailing address:
  • Phone: 337-478-1616
  • Fax: 337-478-1632

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2665
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number707
License Number StateLA

VIII. Authorized Official

Name: MRS. CYNTHIA B SHREWSBERRY
Title or Position: OWNER & THERAPIST
Credential: MA, LPC, LMFT, NCC
Phone: 337-478-1616