OVERTON BROOKS VAMC (NPI# 1285925982) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285925982 |
| Entity Type | Organization |
| Organization Name | OVERTON BROOKS VAMC |
| Practice Address |
510 E Stoner Ave Shreveport LA 71101-4243 |
| Practice Telephone | 3182218411 |
| Mailing Telephone | 3182218411 |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |
| Authorized Official Name | MR. CHARLES DAI-TRIEU CAO (KINESIOTHERAPIST) |
| Authorized Official Telephone | 3182218411 |
| Authorized Official Credential | REGISTERED KT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0850X |
Clinic/Center Specialization: Adult Mental Health |
Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568822658 | Overton Brooks Vamc | Military Hospital | 200 Hartwell Rd, Minden, LA 71055-6365 | 2016-03-02 |
| 1295974574 | Overton Brooks Vamc | General Acute Care Hospital | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2009-02-11 |
| 1396774451 | Overton Brooks Vamc | General Acute Care Hospital | 510 E Stoner Ave, 117, Shreveport, LA 71101-4243 | 2006-07-01 |
| Street Address |
510 E STONER AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4243 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427056456 | Philip Assaad Haddad | Internal Medicine | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2005-07-13 |
| 1124627344 | Tiffany Knesha Williams | Social Worker | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-10-19 |
| 1255938882 | Michael Phillip Parrott | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-10-06 |
| 1013524222 | Brittany Hawkins | Dietitian, Registered | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-09-30 |
| 1598376873 | Martha Stevens | Dietitian, Registered | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-08-11 |
| 1609491844 | Kenneth Charles Sweatman Jr. | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-06-13 |
| 1528682663 | Ashley Nicole Denbrock | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-06-04 |
| 1154941227 | Angel Escobedo | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2020-04-19 |
| 1679116784 | Allisyn Steele | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2019-10-21 |
| 1811530926 | Comis Waddell | Registered Nurse | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2019-10-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 261QM0850X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Adult Mental Health |
| An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225540529 | Tonya Williams | Clinic/Center | 1073 Abbie Glenn Ln, Shreveport, LA 71106-7793 | 2017-10-27 |
| 1790161685 | A Sound Mind Mental Health Consultants, LLC | Clinic/Center | 2924 Knight St, Suite 414, Shreveport, LA 71105-2415 | 2015-08-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871193409 | Three Kords Therapy, LLC | Clinic/Center | 4008 Parliament Dr, Alexandria, LA 71303-3017 | 2020-11-01 |
| 1275159238 | Sonia S. Blauvelt, Ph.d., LLC | Clinic/Center | 11914 Justice Ave Ste B3, Baton Rouge, LA 70816-5315 | 2020-06-24 |
| 1619592839 | Janelle Lavon Grant | Clinic/Center | 2634 Village Ln, Bossier City, LA 71112-2318 | 2020-06-12 |
| 1619432788 | Sanctuary Counseling Services LLC | Clinic/Center | 1901 Manhattan Blvd Ste 115, Harvey, LA 70058-3582 | 2019-02-04 |
| 1962972117 | Williford Wellness Counseling Services, LLC | Clinic/Center | 412 Travis St Ste 214, Lafayette, LA 70503-2432 | 2018-11-30 |
| 1497224349 | Concepts Counseling Center, LLC | Clinic/Center | 3925 N I 10 Service Rd W Ste 222, Metairie, LA 70002-6858 | 2018-11-21 |
| 1992272942 | Maloney Counseling LLC | Clinic/Center | 143 Ridgeway Dr Ste 121, Lafayette, LA 70503-3410 | 2018-10-29 |
| 1497235840 | Imagine Recovery New Orleans, LLC | Clinic/Center | 728 Nashville Ave, New Orleans, LA 70115-3227 | 2018-08-15 |
| 1730697277 | Healthy Mind Forever | Clinic/Center | 8050 W Judge Perez Dr Ste 3500, Chalmette, LA 70043-1742 | 2018-01-18 |
| 1235640095 | Parent Partners LLC | Clinic/Center | 1304 Bertrand Dr Ste D5, Lafayette, LA 70506-9104 | 2017-10-19 |
| Find all providers with the same taxonomy | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on OVERTON BROOKS VAMC.
| 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.