Provider Demographics
NPI:1093901159
Name:CENTER FOR PERSONAL DEVELOPMENT INC
Entity Type:Organization
Organization Name:CENTER FOR PERSONAL DEVELOPMENT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LORIA
Authorized Official - Middle Name:SHELA
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:318-512-1257
Mailing Address - Street 1:PO BOX 4381
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71211-4381
Mailing Address - Country:US
Mailing Address - Phone:318-512-1257
Mailing Address - Fax:318-343-4393
Practice Address - Street 1:208 COLE AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-3814
Practice Address - Country:US
Practice Address - Phone:318-343-4392
Practice Address - Fax:318-343-4393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-21
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA7300251S00000X
LA7268251S00000X
LA1012025251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health