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General NPI Number Information
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NPI Number | 1962193664
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Entity Type | Individual
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Provider Name | MARY RETTA DRUMGOLD M.ED., LPC,NCC
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Gender | Female
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Dates
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Enumeration Date | 05/15/2023
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 2016 TITAN ST
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City | HARVEY
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State | LA
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Zip | 70058-2972
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Country | US
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Telephone | 504-510-6808
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Fax |
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Provider Business Mailing Address
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Address Line | 9321 E CLAIBORNE PKWY
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City | BRIDGE CITY
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State | LA
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Zip | 70094-3751
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Country | US
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Telephone | 504-510-6808
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Fax |
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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 | 9734
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 9734
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License Number State | LA
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