Provider Demographics
NPI:1083197610
Name:CARY, WARREN
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:
Last Name:CARY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3363
Mailing Address - Country:US
Mailing Address - Phone:318-639-9543
Mailing Address - Fax:318-639-9544
Practice Address - Street 1:215 MAIN ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3363
Practice Address - Country:US
Practice Address - Phone:318-639-9543
Practice Address - Fax:318-639-9544
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health