Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Wade Funderburk, PLPC

Individual provider Professional Counselor · NPI 1639749617

Jacob Wade Funderburk, PLPC is a Professional Counselor in Shreveport, Louisiana. Works from 2 locations. Licensed in Louisiana.

Licensed in
LA
In the registry since
2021
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

6240 Greenwood Rd
Shreveport, LA 71119-8413
Phone: (318) 562-6320
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2984 Old Plain Dealing Rd, Plain Dealing, LA 71064-4320 — (318) 508-1301

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence 8671 (LA)

Record details

NPI number1639749617
Entity typeIndividual (Type 1)
GenderMale
Credentials PLPC
Sole proprietorNo
NPI enumeratedJune 30, 2021
Last updated in NPPESNovember 6, 2024
Certification dateNovember 6, 2024

Other providers in Shreveport