MEDICARE: DR. YOLANDA A DUPRE P.D., 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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	2559	LA
2	101YM0800X	Mental Health Counselor	2559	LA
3	101YP2500X	Professional Counselor	2559	LA
4	106H00000X	Marriage & Family Therapist	MFT 952	LA

General Provider Information

NPI Number	:	1699021774
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. YOLANDA A DUPRE P.D., LPC, LMFT

Provider Business Mailing Address
First Line	:	3111 OLD STERLINGTON RD
Second Line	:	APT 175
City	:	MONROE
State	:	LA
Zip	:	71203-2659
Country	:	US
Telephone Number	:	318-450-5065
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 TRENTON ST
Second Line	:	STE B
City	:	WEST MONROE
State	:	LA
Zip	:	71291-2966
Country	:	US
Telephone Number	:	318-450-5065
Fax Number	:

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

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	07/26/2012

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