Healthcare Provider Details

I. General information

NPI: 1174609721
Provider Name (Legal Business Name): COUNCIL FOR THE ADVANCEMENT OF SOCIAL SERVICES AND EDUCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 POLK ST
MANSFIELD LA
71052-2520
US

IV. Provider business mailing address

907 POLK ST
MANSFIELD LA
71052-2520
US

V. Phone/Fax

Practice location:
  • Phone: 318-872-1015
  • Fax: 318-872-1055
Mailing address:
  • Phone: 318-872-1015
  • Fax: 318-872-1055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MARY M CHUMLEY
Title or Position: CEO
Credential:
Phone: 318-688-3350