Provider Demographics
NPI:1336457852
Name:DUNLAP, CYNTHIA A (LPC)
Entity Type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:A
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 PIERREMONT RD
Mailing Address - Street 2:SUITE 255
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106
Mailing Address - Country:US
Mailing Address - Phone:318-309-7436
Mailing Address - Fax:903-766-2462
Practice Address - Street 1:910 PIERREMONT RD STE 255
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2063
Practice Address - Country:US
Practice Address - Phone:318-309-7436
Practice Address - Fax:903-766-2462
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3708101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA3708OtherSELF