Provider Demographics
NPI:1336385053
Name:ALLEN, ANN VUNCANNON (MA, LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:VUNCANNON
Last Name:ALLEN
Suffix:
Gender:F
Credentials:MA, LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 CHRISTIAN LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70458-1350
Mailing Address - Country:US
Mailing Address - Phone:985-781-7353
Mailing Address - Fax:985-781-7354
Practice Address - Street 1:1150 W CAUSEWAY APPROACH
Practice Address - Street 2:STE. A
Practice Address - City:MANDEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70471-3038
Practice Address - Country:US
Practice Address - Phone:985-781-7353
Practice Address - Fax:985-781-7354
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2015-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3003101YP2500X
LA527106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist