Provider Demographics
NPI:1659589356
Name:DUMELOD, CESAR A (LMFT)
Entity Type:Individual
Prefix:MR
First Name:CESAR
Middle Name:A
Last Name:DUMELOD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ASHVILLE CT
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31210-1669
Mailing Address - Country:US
Mailing Address - Phone:478-474-4035
Mailing Address - Fax:478-474-7713
Practice Address - Street 1:310 ASHVILLE CT
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31210-1669
Practice Address - Country:US
Practice Address - Phone:478-474-4035
Practice Address - Fax:478-474-7713
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001015106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist