Individual
MR. MICHAEL MUMME MCSHAN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.ED., LPC, LAC, NCC
Contact information
Practice address
900 WILKINSON ST, MANDEVILLE, LA 70448-3533
(985) 624-4450
Mailing address
102E COVINGTON MEADOW CIR STE E, COVINGTON, LA 70433-6606
(985) 237-0363
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
302349
LA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1492
LA
101YP2500X
Professional Counselor
5377
LA
Other
Enumeration date
01/08/2014
Last updated
03/22/2016
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