Provider Demographics
NPI:1982976155
Name:CUMMINGS, LACOYA DANIELLE (LPC)
Entity Type:Individual
Prefix:
First Name:LACOYA
Middle Name:DANIELLE
Last Name:CUMMINGS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5254 DANTON PL
Mailing Address - Street 2:
Mailing Address - City:KEITHVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71047-6557
Mailing Address - Country:US
Mailing Address - Phone:318-422-0484
Mailing Address - Fax:
Practice Address - Street 1:543 STONER AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4122
Practice Address - Country:US
Practice Address - Phone:318-422-0484
Practice Address - Fax:318-673-9901
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-03
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X
LA3953101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No251B00000XAgenciesCase Management