JOHNSON BEHAVIORAL HEALTH GROUP (NPI# 1063019156) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063019156 |
| Entity Type | Organization |
| Organization Name | JOHNSON BEHAVIORAL HEALTH GROUP |
| Practice Address |
4830 Line Ave Ste 302 Shreveport LA 71106-1530 |
| Practice Telephone | 3183794488 |
| Mailing Telephone | 3183794488 |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2020-10-02 |
| Authorized Official Name | ABIGAIL JOHNSON (CEO) |
| Authorized Official Telephone | 3183794488 |
| Authorized Official Credential | APRN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
Ambulatory Health Care Facilities |
| Street Address |
4830 LINE AVE STE 302 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-1530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972008332 | Andrew Joseph Brouillette | Dentist | 385 Bert Kouns Industrial Loop Ste 700, Shreveport, LA 71106 | 2018-03-28 |
| 1548775885 | David Wayne Spears | Pharmacist | 10460 Norris Ferry Road, Shreveport, LA 71106 | 2017-12-08 |
| 1225559263 | Susan Anderson Roblow | Physical Therapist | 921 Unadilla Street, Shreveport, LA 71106 | 2017-06-29 |
| 1134656382 | James Lowder | Dentist | 8691 Line Ave Ste 300, Shreveport, LA 71106 | 2017-05-18 |
| 1144753708 | Laverne Brantley | Counselor | 328 E 69th St, Shreveport, LA 71106 | 2017-04-10 |
| 1437690849 | Biostat Laboratories, LLC | Clinical Medical Laboratory | 9742 Saint Vincent Ave Ste 200, Shreveport, LA 71106 | 2017-03-17 |
| 1841730728 | Cedric Thomas | Case Manager/Care Coordinator | 6811 Fairfield Avenue, Shreveport, LA 71106 | 2017-02-27 |
| 1225576192 | Nick Vergis | Pharmacist | 5828 Line Avenue, Shreveport, LA 71106 | 2017-02-10 |
| 1184162554 | Marilyn Johnson | Case Manager/Care Coordinator | 9245 Wallace Lake Rd Ste A, Shreveport, LA 71106 | 2017-02-06 |
| 1417499740 | Pamela Lee | Counselor | 8802 Coyth Ln, Shreveport, LA 71106 | 2016-11-17 |
| Find all providers in zip 71106 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104479799 | Families First Counseling and Wellness, LLC | Clinic/Center | 2020 Hollywood Ave, Shreveport, LA 71108-3920 | 2019-07-22 |
| 1174087530 | Jl Counseling | Clinic/Center | 1545 Line Ave Ste 320e, Shreveport, LA 71101-4630 | 2019-01-29 |
| 1568948396 | Scere's Mediation & Counseling Services | Clinic/Center | 610 Marshall St Ste 625, Shreveport, LA 71101-3652 | 2018-07-16 |
| 1700384831 | Zodiac Holding Group | Clinic/Center | 3611 Greenway Pl, Shreveport, LA 71105-2011 | 2018-01-23 |
| 1235539644 | Envision Counseling Services LLC | Clinic/Center | 7505 Pines Rd Ste 1230, Shreveport, LA 71129-3900 | 2014-09-04 |
| 1457773657 | Comprehensive Assessments, Inc. | Clinic/Center | 3010 Knight St, Suite 125, Shreveport, LA 71105-2553 | 2014-01-08 |
| 1366687527 | Northwest Cmhc, L.L.C. | Clinic/Center | 2121 Fairfield Ave, Suite 210/220, Shreveport, LA 71104-2057 | 2008-12-02 |
| 1598950370 | Renaissance Healthcare LLC | Clinic/Center | 3321 Youree Dr, Suite 100, Shreveport, LA 71105-2123 | 2007-09-13 |
| 1568534857 | Community Enrichment Programs LLC | Clinic/Center | 842 Margaret Pl, Shreveport, LA 71101-4521 | 2006-11-14 |
| 1427137074 | Rehabilitation Services of Northwest Louisiana, LLC | Clinic/Center | 2525 Youree Dr, Suite 110, Shreveport, LA 71104-3600 | 2006-11-03 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71106 |
Please comment or provide details below to improve the information on JOHNSON BEHAVIORAL HEALTH GROUP.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.