Provider Demographics
NPI:1477820132
Name:AMOS, WINFORD LOUIS (LPC, LAC, CCS)
Entity Type:Individual
Prefix:
First Name:WINFORD
Middle Name:LOUIS
Last Name:AMOS
Suffix:
Gender:M
Credentials:LPC, LAC, CCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3226 GRAND POINT HWY
Mailing Address - Street 2:
Mailing Address - City:BREAUX BRIDGE
Mailing Address - State:LA
Mailing Address - Zip Code:70517-6221
Mailing Address - Country:US
Mailing Address - Phone:337-456-6166
Mailing Address - Fax:337-456-4830
Practice Address - Street 1:2506 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-3238
Practice Address - Country:US
Practice Address - Phone:337-456-6166
Practice Address - Fax:337-456-4830
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1204101YA0400X
LA5018101YP2500X, 101YP2500X
TX86294101YP2500X
101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional