MR. GREGORY H GENTRY (NPI# 1174047856) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174047856 |
| Entity Type | Individual |
| Full Name | MR. GREGORY H GENTRY |
| Credential | LAC |
| Practice Address |
363 Sandefur Dr Shreveport LA 71105-3245 |
| Practice Telephone | (318) 752-4454 |
| Mailing Telephone | 3187524454 |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2017-08-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
116 | LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | ADDICTIVE DISORDER REGULATORY AUTHORITY | 116 | 01 |
| Street Address |
363 SANDEFUR DR |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-3245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| 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 |
| 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 |
| 1871786137 | John Philip Epling | Counselor | 2303 Line Ave, Shreveport, LA 71104-2130 | 2007-08-21 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on MR. GREGORY H GENTRY.
| 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.