Provider Demographics
NPI:1750705935
Name:KAY DORE COUNSELING CLINIC
Entity type:Organization
Organization Name:KAY DORE COUNSELING CLINIC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MISS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-475-5981
Mailing Address - Street 1:4205 RYAN ST
Mailing Address - Street 2:BOX 91895
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70609-1895
Mailing Address - Country:US
Mailing Address - Phone:337-475-5981
Mailing Address - Fax:337-562-4221
Practice Address - Street 1:4205 RYAN ST
Practice Address - Street 2:BOX 91895
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70609-1895
Practice Address - Country:US
Practice Address - Phone:337-475-5981
Practice Address - Fax:337-562-4221
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCNEESE STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty