SHALISA YOUNG (NPI# 1275041170) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275041170 |
| Entity Type | Individual |
| Full Name | SHALISA YOUNG |
| Practice Address |
2620 Centenary Blvd Ste 312 Shreveport LA 71104-3358 |
| Practice Telephone | 3186319935 |
| Mailing Telephone | 3186819935 |
| Enumeration Date | 2018-01-14 |
| Last Update Date | 2018-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
010541375 | LA | Behavioral Health & Social Service Providers |
| Street Address |
2620 CENTENARY BLVD STE 312 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-3358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| 1700398807 | Curtis Ray Davis II | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104-3358 | 2017-10-30 |
| 1063951366 | Dorothy Ray | Case Manager/Care Coordinator | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2017-02-20 |
| 1720520414 | Victoria Morris | Case Manager/Care Coordinator | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2016-11-10 |
| 1912449067 | Keinekia Rascoe | Case Manager/Care Coordinator | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2016-11-07 |
| 1770938821 | Superior Counseling | Community/Behavioral Health | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104-3358 | 2016-04-26 |
| 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 |
| 1114398708 | Carolyn Morris | Case Manager/Care Coordinator | 640 Prospect St Apt 1, Shreveport, LA 71104 | 2015-10-08 |
| Find all providers in zip 71104 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786502 | Erik Rasmussen | Counselor | 670 Albemarle Dr Ste 700, Shreveport, LA 71106-5946 | 2020-09-25 |
| 1043842750 | Creative Community Counseling LLC | Counselor | 2920 Knight St Ste 131, Shreveport, LA 71105-2412 | 2020-02-11 |
| 1477191591 | Keona Chequise Kidd | Counselor | 2829 Dunlap St, Shreveport, LA 71103-2244 | 2019-12-19 |
| 1336781632 | A New Beginning Counseling Services, LLC | Counselor | 9441 Oleander Dr, Shreveport, LA 71118-4008 | 2019-10-08 |
| 1841840311 | Theresa Davidson Snow | Counselor | 820 Jordan St Ste 510w, Shreveport, LA 71101-4526 | 2019-09-17 |
| 1962057737 | Mariana Penny | Counselor | 152 E College St, Shreveport, LA 71104-2510 | 2019-08-07 |
| 1528622818 | Kendal Redel | Counselor | 10011 Hanover Dr, Shreveport, LA 71115-3430 | 2019-04-23 |
| 1962960351 | Brandon Lewis-graham | Counselor | 3201 Knight St Apt 2206, Shreveport, LA 71105-2749 | 2019-03-05 |
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1659840312 | Donna Brown Franks | Counselor | 236 E Gregg St, Shreveport, LA 71104-5119 | 2018-11-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
Please comment or provide details below to improve the information on SHALISA YOUNG.
| 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.