Organization
AWAKENING CHRISTIAN COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. WENDY BORDELON MSW, LCSW, BACS (CLINICAL SOCIAL WORKER)
(318) 419-6364
Entity
Organization
Contact information
Practice address
7215 SHREVEPORT HWY, PINEVILLE, LA 71360-2725
(318) 419-6364
Mailing address
1737 WATSON RD, PINEVILLE, LA 71360-9038
(318) 419-6364
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
4150
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891742185
NPI INDIVIDUAL PROVIDER NUMBER
LA
Enumeration date
03/04/2011
Last updated
03/04/2011
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