Individual
MR. BENJAMIN F VIRDEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
L.A.C.
Contact information
Practice address
401 RAINBOW DR UNIT 35, PINEVILLE, LA 71360-6979
(318) 487-5191
Mailing address
49 KENDALL LN, BOYCE, LA 71409-9708
(318) 793-0944
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
L.A.C. # 753
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G9759
BLUECROSS BLUESHIELD
LA
Enumeration date
08/23/2006
Last updated
05/13/2010
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