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General NPI Number Information
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NPI Number | 1720709603
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Entity Type | Organization
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Legal Business Name | MUSGROVE CONSULTING LLC
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Dates
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Enumeration Date | 09/08/2022
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Last Update Date | 04/07/2023
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Provider Practice Location Address
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Address Line | 105 MADISON SQ
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City | MINDEN
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State | LA
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Zip | 71055-3095
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Country | US
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Telephone | 318-734-8553
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 83
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City | DOYLINE
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State | LA
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Zip | 71023-0083
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Country | US
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Telephone | 318-734-8553
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Fax | 844-769-7920
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Authorized Official
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Title or Position | PROVIDER/OWNER
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Name | MS. AUDRIA LYNETTE MUSGROVE
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Credential | MA, LPC, BC-TMH
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Telephone | 318-505-3618
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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 |
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License Number State |
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