Provider Demographics
NPI:1780740001
Name:CYNTHIA B. SHREWSBERRY, MA,LPC, LMFT, NCC, LLC
Entity type:Organization
Organization Name:CYNTHIA B. SHREWSBERRY, MA,LPC, LMFT, NCC, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER & THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:B
Authorized Official - Last Name:SHREWSBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC, LMFT, NCC
Authorized Official - Phone:337-478-1616
Mailing Address - Street 1:PO BOX 7452
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70606-7452
Mailing Address - Country:US
Mailing Address - Phone:337-478-1616
Mailing Address - Fax:337-478-1632
Practice Address - Street 1:108 STATE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5718
Practice Address - Country:US
Practice Address - Phone:337-478-1616
Practice Address - Fax:337-478-1632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA707106H00000X
LA2665101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty