Provider Demographics
NPI:1033329180
Name:FAMILY AND YOUTH COUNSELING AGENCY, INC.
Entity Type:Organization
Organization Name:FAMILY AND YOUTH COUNSELING AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:DUPLECHIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-436-9533
Mailing Address - Street 1:220 LOUIE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-7250
Mailing Address - Country:US
Mailing Address - Phone:337-436-9533
Mailing Address - Fax:337-439-9941
Practice Address - Street 1:220 LOUIE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70601-7250
Practice Address - Country:US
Practice Address - Phone:337-436-9533
Practice Address - Fax:337-439-9941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2011-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA176251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health