Provider Demographics
NPI:1316398761
Name:DESTINY COUNSELING AGENCY
Entity Type:Organization
Organization Name:DESTINY COUNSELING AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ZEIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:N/A
Authorized Official - Phone:318-294-2158
Mailing Address - Street 1:2924 KNIGHT ST STE 436
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-2431
Mailing Address - Country:US
Mailing Address - Phone:318-294-2158
Mailing Address - Fax:855-387-0705
Practice Address - Street 1:2924 KNIGHT ST STE 436
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-2431
Practice Address - Country:US
Practice Address - Phone:318-294-1371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-27
Last Update Date:2019-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health