MEDICARE: CYNTHIA B. SHREWSBERRY, MA,LPC, LMFT, NCC, LLC

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	106H00000X	Marriage & Family Therapist	707	LA
2	101YP2500X	Professional Counselor	2665	LA

General Provider Information

NPI Number	:	1780740001
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CYNTHIA B. SHREWSBERRY, MA,LPC, LMFT, NCC, LLC

Provider Business Mailing Address
First Line	:	PO BOX 7452
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70606-7452
Country	:	US
Telephone Number	:	337-478-1616
Fax Number	:	337-478-1632

Provider Business Practice Location Address
First Line	:	108 STATE ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-5718
Country	:	US
Telephone Number	:	337-478-1616
Fax Number	:	337-478-1632

Authorized Official
Title or Position	:	OWNER & THERAPIST
Name	:	MRS. CYNTHIA B SHREWSBERRY
Credential	:	MA, LPC, LMFT, NCC
Telephone Number	:	337-478-1616

Provider Enumeration Date	:	12/29/2006
Last Update Date	:	07/07/2015

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