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General NPI Number Information
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NPI Number | 1770811374
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Entity Type | Individual
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Provider Name | LUSAN D. LADD LMFT, LPC
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Gender | Female
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Dates
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Enumeration Date | 11/20/2009
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 3800 S W S YOUNG DR STE 104A
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City | KILLEEN
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State | TX
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Zip | 76542-3312
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Country | US
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Telephone | 254-519-1150
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Fax | 254-519-1151
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Provider Business Mailing Address
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Address Line | 3800 S W S YOUNG DR STE 104A
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City | KILLEEN
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State | TX
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Zip | 76542-3312
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Country | US
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Telephone | 254-519-1150
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Fax | 254-519-1151
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 64044
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License Number State | TX
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