Provider Demographics
NPI:1073223210
Name:CDL COUNSELING SERVICES, LLC
Entity Type:Organization
Organization Name:CDL COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:P-LPC
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHANDLER
Authorized Official - Middle Name:DAVIS
Authorized Official - Last Name:LAWS
Authorized Official - Suffix:
Authorized Official - Credentials:P-LPC, NCC, BC-TMH
Authorized Official - Phone:662-801-5535
Mailing Address - Street 1:1005 PARKVIEW LN
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MS
Mailing Address - Zip Code:38655-2567
Mailing Address - Country:US
Mailing Address - Phone:662-801-5535
Mailing Address - Fax:
Practice Address - Street 1:2690 W OXFORD LOOP STE 146
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MS
Practice Address - Zip Code:38655-5575
Practice Address - Country:US
Practice Address - Phone:662-801-5535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-29
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health