ACTIVE RECOVERY LLC (NPI# 1285998716) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285998716 |
| Entity Type | Organization |
| Organization Name | ACTIVE RECOVERY LLC |
| Practice Address |
3821 Southern Ave Active Recovery LLC Shreveport LA 71106 |
| Mailing Address |
3821 Southern Ave Shreveport LA 71106 |
| Practice Telephone | 3189468157 |
| Practice Fax Number | 3182165868 |
| Mailing Telephone | 3189468157 |
| Mailing Fax Number | 3182165868 |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2015-07-09 |
| Authorized Official Name | MRS. THERESE D SCHAFFNER (CEO) |
| Authorized Official Telephone | 3182101539 |
| Authorized Official Credential | MA, LAC, PLPC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | LPC LMHP 2785 | LA | Agencies |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LAC 896 | LA | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
LA1454 | LA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053883850 | Active Recovery LLC | Clinic/Center | 3906 Hardy St # 15, Hattiesburg, MS 39402-1683 | 2018-12-19 |
| Street Address |
3821 SOUTHERN AVE ACTIVE RECOVERY LLC |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083239735 | Charles Robert Yates Jr. | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2020-06-09 |
| 1689211047 | Constance Darby | Social Worker | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2019-12-04 |
| 1215570650 | Marshall Turner IIi | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2019-10-17 |
| 1780153270 | Melissa Troy | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2018-11-14 |
| 1093209967 | Robert Francis Conway Jr. | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2018-06-14 |
| 1093204554 | Anna-katrina Keco | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2018-05-09 |
| 1952815458 | Kellye Jean Lewis | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2017-11-21 |
| 1992225650 | Kathryn Costello | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2017-06-23 |
| 1346786373 | Amanda Veuleman | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2017-01-14 |
| 1962865279 | Jeremy Lindsay | Counselor | 3821 Southern Ave, Shreveport, LA 71106-1033 | 2016-04-04 |
| Find all providers in the same location | ||||
| 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 | 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 | 71106 |
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| 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.