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NPI Code Detail

MEDICARE: ARCELL BODDEN LPC

MEDICARE: ARCELL BODDEN LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional Counselor4313LA

General Provider Information

NPI Number : 1124499710
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARCELL BODDEN LPC
Provider Business Mailing Address
First Line : 15049 FLORIDA BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70819-2602
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 15049 FLORIDA BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70819-2602
Country : US
Telephone Number : 225-326-0238
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/08/2015
Last Update Date : 10/08/2015

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