CASANDRA WALLACE (NPI# 1518490465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518490465 |
| Entity Type | Individual |
| Full Name | CASANDRA WALLACE |
| Credential | M.S. |
| Practice Address |
6811 Fairfield Ave Shreveport LA 71106-3803 |
| Practice Telephone | 3186703975 |
| Mailing Telephone | 3186703975 |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YS0200X |
Counselor Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
6811 FAIRFIELD AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71106-3803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104286889 | Paulette Gorman | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-02-24 |
| 1457701526 | Erica Hill | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-06-20 |
| 1750738357 | Patricia Walker | Counselor | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-05-24 |
| 1831545029 | Jessica Jones | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-05-06 |
| 1689036014 | Alicia Waruszcak | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-24 |
| 1376905133 | Temper Stokes | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-22 |
| 1386006161 | Kiani Houston | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-22 |
| 1376904615 | Brandon Hardy | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-15 |
| 1003276270 | Melissa Deshaun Neal | Case Manager/Care Coordinator | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-02 |
| 1669832838 | Malisha Ellis | Social Worker | 6811 Fairfield Ave, Shreveport, LA 71106-3803 | 2016-03-02 |
| 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 | 101YS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013407006 | Kimron Smith | Counselor | 7550 Pines Road Suite 1115, Shreveport, LA 71129 | 2018-05-15 |
| 1215458930 | Yolanda Hensley Dodson | Counselor | 2924 Knight Street Bldg. 4 Suite 426, Shreveport, LA 71105 | 2017-07-03 |
| 1326597964 | Carylon Nickelberry | Counselor | 4311 Gabriel Cir, Shreveport, LA 71109-6602 | 2016-09-23 |
| 1437532249 | Ashley Enders Clinger | Counselor | 820 Jordan St Ste 485, Shreveport, LA 71101-4533 | 2015-06-30 |
| 1669945986 | Melvin Lars | Counselor | 4111 Metro Dr Ste B, Shreveport, LA 71109-6001 | 2019-01-09 |
| 1154879161 | Claude J Russell IIi | Counselor | 1406 Hawn Ave, Shreveport, LA 71107-6532 | 2016-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720558026 | Brendan Michael Turner | Counselor | 1035 Calhoun St Fl 3, New Orleans, LA 70118-5913 | 2018-11-29 |
| 1851809214 | Latoya M Gray | Counselor | 132 Kelly St, Natchitoches, LA 71457 | 2018-01-18 |
| 1124535562 | Lisa M Miller | Counselor | 1211 Austin Rd, Opelousas, LA 70570 | 2018-01-08 |
| 1720505076 | Amy C Rochon | Counselor | 315 Amesbury Drive, Apt 292, Lafayette, LA 70507 | 2017-08-28 |
| 1952849085 | Emmar Mayberry | Counselor | 7551 Anne Marie Ct, New Orleans, LA 70128 | 2017-02-09 |
| 1780033175 | Compassionate Hearts Ministry | Counselor | 5709 Goodland Trce, Alexandria, LA 71301-2655 | 2016-06-07 |
| 1366800328 | Diversion Youth and Family Counseling LLC | Counselor | 12524 Merlin Ave, Baton Rouge, LA 70816-2494 | 2016-02-05 |
| 1790157121 | Trevis Alford | Counselor | 3845 E Loyola Dr, Kenner, LA 70065-2548 | 2015-10-25 |
| 1730598202 | Rebecca Teasley | Counselor | 3800 Highway 1216, Zwolle, LA 71486-3081 | 2014-08-08 |
| 1619391471 | Jenee Alleman | Counselor | 809 Summer Breeze Dr Apt 1002, Baton Rouge, LA 70810-6297 | 2014-02-13 |
| Find all providers with the same taxonomy | ||||
| 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.