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General NPI Number Information
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NPI Number | 1245403658
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Entity Type | Individual
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Provider Name | CYNTHIA NASSAR LPC, LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/07/2008
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Last Update Date | 06/12/2014
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Provider Practice Location Address
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Address Line | 4216 LAKE ST
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City | LAKE CHARLES
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State | LA
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Zip | 70605-4308
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Country | US
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Telephone | 337-540-4205
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Fax | 337-474-8123
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Provider Business Mailing Address
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Address Line | PO BOX 6446
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City | LAKE CHARLES
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State | LA
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Zip | 70606-6446
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Country | US
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Telephone | 337-540-4205
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Fax | 337-474-8123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2140
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 574
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License Number State | LA
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