Provider Demographics
NPI:1508466715
Name:DYCHE, SHONA D (LPC, NCC, NCSC)
Entity Type:Individual
Prefix:
First Name:SHONA
Middle Name:D
Last Name:DYCHE
Suffix:
Gender:F
Credentials:LPC, NCC, NCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1324 VIOLET AVE
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71112-4639
Mailing Address - Country:US
Mailing Address - Phone:318-423-3440
Mailing Address - Fax:
Practice Address - Street 1:1324 VIOLET AVE
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71112-4639
Practice Address - Country:US
Practice Address - Phone:318-423-3440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3740101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor