Provider Demographics
NPI:1063889137
Name:CYPRESS CENTER FOR COUNSELING, LLC
Entity type:Organization
Organization Name:CYPRESS CENTER FOR COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:JOSE
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPC-S, LMFT
Authorized Official - Phone:225-205-7508
Mailing Address - Street 1:2924 BRAKLEY DR
Mailing Address - Street 2:SUITE B2
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-2333
Mailing Address - Country:US
Mailing Address - Phone:225-205-7508
Mailing Address - Fax:225-214-0068
Practice Address - Street 1:38384 HIGHWAY 42
Practice Address - Street 2:SUITE B
Practice Address - City:PRAIRIEVILLE
Practice Address - State:LA
Practice Address - Zip Code:70769-4011
Practice Address - Country:US
Practice Address - Phone:225-313-6716
Practice Address - Fax:225-313-6721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2772261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)