MEDICARE: BOBBIE L. BYRD CIT

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	CIT-6057	LA

General Provider Information

NPI Number	:	1295699098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBIE L. BYRD CIT

Provider Business Mailing Address
First Line	:	115 OAKLAND ST
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-2813
Country	:	US
Telephone Number	:	318-503-7061
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 OLD DARBONNE RD
Second Line	:
City	:	WEST MONROE
State	:	LA
Zip	:	71291-4816
Country	:	US
Telephone Number	:	318-503-7061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2025
Last Update Date	:	12/15/2025

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