MR. ERIC SHANE BLAIR (NPI# 1356495006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356495006 |
| Entity Type | Individual |
| Full Name | MR. ERIC SHANE BLAIR |
| Credential | M.S. |
| Practice Address |
242 West Shamrock Street Pineville LA 71360 |
| Mailing Address |
219 Twin Oaks Rd W Pineville LA 71360-7744 |
| Practice Telephone | 3184846850 |
| Practice Fax Number | 3184846506 |
| Mailing Telephone | 3184846850 |
| Mailing Fax Number | 3184846506 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2018-08-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
1472 | LA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
242 WEST SHAMROCK STREET |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710063763 | Vijaya L. Boppana | Psychiatry & Neurology | 242 West Shamrock Street, Pineville, LA 71360 | 2006-10-31 |
| 1427365600 | Shamrock Street Pharmacy | Community/Behavioral Health | 242 West Shamrock Street, Unit 2, Room 120, Pineville, LA 71360-6439 | 2010-09-09 |
| 1194845537 | Patricia Ann Johnson | Counselor | 242 West Shamrock Street, Pineville, LA 71360-6439 | 2007-03-30 |
| 1548300643 | Jose Eladio Colls | Counselor | 242 West Shamrock Street, Pineville, LA 71360 | 2007-02-07 |
| 1629118781 | Debra Louise Burton | Counselor | 242 West Shamrock Street, Pineville, LA 71360-6439 | 2007-02-07 |
| 1699829309 | Rebecca I Craig | Counselor | 242 West Shamrock Street, Pineville, LA 71360-0473 | 2007-01-22 |
| 1023161247 | Dixie K Orris | Social Worker | 242 West Shamrock Street, Pineville, LA 71360 | 2007-01-19 |
| 1750467718 | Rama Boppana | Psychiatry & Neurology | 242 West Shamrock Street, Pineville, LA 71360 | 2006-10-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
| Find all providers in zip 71360 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225637796 | Cindy Verdoorn | Counselor | 10831 Pineville Rd Unit 9, Pineville, NC 28134-8137 | 2020-10-25 |
| 1578937397 | David Brocato | Counselor | 401 West Shamrock, Pineville, LA 71361 | 2015-11-17 |
| 1316343130 | Lenn Neal | Counselor | 62 Phil Gibson Rd, Pineville, KY 40977 | 2014-11-05 |
| 1710092945 | John David Murphy | Counselor | 2900 Donahue Ferry Rd, Pineville, LA 71360-4516 | 2006-08-20 |
| 1801900915 | Betty Tetu | Counselor | Unit 6 Meadow Lane, Clsh Red River Treatment Center, Pineville, LA 71360 | 2006-08-18 |
| 1306950449 | Phillip Michael Coco | Counselor | 401 Rainbow Dr Unit 6, Pineville, LA 71360-6979 | 2006-08-18 |
| 1639282627 | Michael James Lofton | Counselor | 400 E Shamrock, Pineville, LA 71360-6558 | 2006-08-16 |
| 1255348868 | Ray J. Fruge | Counselor | 401 Rainbow Drive, Unit 35, Pineville, LA 71360 | 2006-08-03 |
| 1306800289 | Department of Health and Hospitals | Counselor | 242 West Shamrock, Unit 1, Pineville, LA 71360 | 2006-04-17 |
| 1841832854 | Audrey Carter | Counselor | 210 Laurel St, Pineville, LA 71360-4662 | 2019-10-10 |
| Find all providers in PINEVILLE | ||||
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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.