1467860205 NPI number — YNG COUNSELING & CONSULTING, LLC

Table of content: KIM MARIE DARE PT (NPI 1093765141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467860205 NPI number — YNG COUNSELING & CONSULTING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YNG COUNSELING & CONSULTING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467860205
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/24/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1308 PAUL MAILLARD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LULING
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70070-4548
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
504-782-4269
Provider Business Mailing Address Fax Number:
985-785-6077

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1308 PAUL MAILLARD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LULING
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70070-4548
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
504-782-4269
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/24/2014

Additional Information

Authorized Official

Authorized Official Last Name:
GASPARD
Authorized Official First Name:
YVONNE
Authorized Official Middle Name:
BYRD
Authorized Official Title or Position:
LICENSED PROFESSIONAL COUNSELOR
Authorized Official Telephone Number:
504-782-4269

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  1075 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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