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NPI Code Detail

MEDICARE: DONALD D SHORT LPC, LMFT

MEDICARE:   DONALD D SHORT  LPC, LMFT
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 Counselor2669LA
2106H00000XMarriage & Family Therapist648LA

General Provider Information

NPI Number : 1548531452
Entity Type Code : Individual
Provider Name (Legal Business Name) : DONALD D SHORT LPC, LMFT
Provider Business Mailing Address
First Line : 224 LORMAND RD
Second Line :
City : SCOTT
State : LA
Zip : 70583-4420
Country : US
Telephone Number : 337-230-0533
Fax Number : 337-856-8127
Provider Business Practice Location Address
First Line : 110 TRAVIS ST
Second Line : STE 204
City : LAFAYETTE
State : LA
Zip : 70503-2452
Country : US
Telephone Number : 337-230-0533
Fax Number : 337-856-8127
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2012
Last Update Date : 01/24/2012

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Directions to “ DONALD D SHORT LPC, LMFT” Practice Location

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