Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB WADE FUNDERBURK, PLPC
ActiveJACOB WADE FUNDERBURK, PLPC is a Professional Counselor healthcare provider located in SHREVEPORT, Louisiana. NPI 1639749617 is currently active in the NPPES registry. Verify at CMS.
Professional Counselor · SHREVEPORT, LA
Registration Details
- NPI Number
- 1639749617
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 30, 2021 (5.1189396704909 yrs)
- Last Updated
- Nov 6, 2024
- License
-
8671 (LA)
Practice Information
- Address
-
6240 GREENWOOD RDSHREVEPORT, LA, 711198413Browse LA providers · Browse ZIP 71119
- Phone
- 3185626320
- Primary Specialty
-
Professional Counselor
101YP2500X
Other Professional Counselor Providers in SHREVEPORT, LA
| Name | Credential | NPI |
|---|---|---|
| JUANITA CARMELLA JONES | MA, NCC, LPC | 1013911775 |
| DR. GEORGE M WOLCOTT | LPC, LMFT, EDD | 1699743286 |
| DR. DUDLEY G CHEWNING | LMFT, LPC | 1932177078 |
| MRS. LINDA H WATTS | LPC | 1568498707 |
| MR. DANIEL GRANTHAM | LPC | 1710916044 |
| TERRESA S ROBINSON | LPC | 1598794000 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.