MR. ANDREW ANTHONY COMEAUX (NPI# 1083644645) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083644645 |
| Entity Type | Individual |
| Full Name | MR. ANDREW ANTHONY COMEAUX |
| Credential | L.C.S.W. |
| Practice Address |
2625 Line Ave Suite 106 Shreveport LA 71104-3047 |
| Mailing Address |
3602 Gilbert Dr Shreveport LA 71104-5002 |
| Practice Telephone | 3185603458 |
| Practice Fax Number | 3185540294 |
| Mailing Telephone | 3185603458 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
0189 | LA | Behavioral Health & Social Service Providers |
| X | 1041C0700X |
Social Worker Specialization: Clinical |
4679 | LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1163538 | 05 | |
| LA | TRICARE | 275218 | 01 |
| Street Address |
2625 LINE AVE SUITE 106 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-3047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689834400 | Warren David. Long | Specialist | 2625 Line Ave, 155, Shreveport, LA 71104-3047 | 2008-06-16 |
| 1659473908 | Warren Long | Psychiatry & Neurology | 2625 Line Ave, Suite 155, Shreveport, LA 71104-3047 | 2006-09-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942814389 | Courtney Rayburn | Counselor | 9413 Prestonwood Dr, Shreveport, LA 71115-3733 | 2020-09-02 |
| 1669007951 | Tamara 'tammy' Larck | Counselor | 1525 Fullilove Drive, Shreveport, LA 71111 | 2020-03-06 |
| 1518505601 | Samantha Klingenberg | Counselor | 910 Pierremont Rd Ste 300, Shreveport, LA 71106-2056 | 2019-12-19 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1396255980 | Christa Walker-williams | Counselor | 525 Crockett St, Shreveport, LA 71101-3601 | 2017-10-09 |
| 1174047856 | Gregory H Gentry | Counselor | 363 Sandefur Dr, Shreveport, LA 71105-3245 | 2017-08-03 |
| 1538615067 | Jesse Fallis | Counselor | New Day Recovery/ Shreveport, 6240 Greenwood Rd, Shreveport, LA 71119 | 2016-08-25 |
| 1760762470 | Jacqueline A. Danzell, Lcsw, LLC | Counselor | 910 Pierremont Rd Ste 410, Shreveport, LA 71106-2056 | 2011-08-25 |
| 1811291099 | Barbara Marie Allen | Counselor | 5100 Pine Hill Rd, Shreveport, LA 71107-2604 | 2011-01-03 |
| 1063609782 | Ross Githens | Counselor | 520 Olive St, Shreveport, LA 71104-2312 | 2007-09-26 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
Please comment or provide details below to improve the information on MR. ANDREW ANTHONY COMEAUX.
| 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.