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General NPI Number Information
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NPI Number | 1316398761
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Entity Type | Organization
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Legal Business Name | DESTINY COUNSELING AGENCY
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Dates
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Enumeration Date | 06/27/2016
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 2924 KNIGHT ST STE 436
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City | SHREVEPORT
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State | LA
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Zip | 71105-2431
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Country | US
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Telephone | 318-294-1371
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Fax |
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Provider Business Mailing Address
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Address Line | 2924 KNIGHT ST STE 436
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City | SHREVEPORT
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State | LA
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Zip | 71105-2431
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Country | US
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Telephone | 318-294-2158
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Fax | 855-387-0705
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CYNTHIA C ZEIGLER
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Credential | N/A
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Telephone | 318-294-2158
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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