JESSE FALLIS (NPI# 1538615067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1538615067 |
| Entity Type | Individual |
| Full Name | JESSE FALLIS |
| Practice Address |
New Day Recovery/ Shreveport 6240 Greenwood Rd Shreveport LA 71119 |
| Mailing Address |
5655 N Lakeshore Dr Shreveport LA 71107-9382 |
| Practice Telephone | 3185626320 |
| Mailing Telephone | 3182182360 |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2019-04-11 |
| 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) |
7191 | LA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6040 Old Mooringsport Rd, Shreveport, LA 711072026 | 3182182360 |
| Street Address |
NEW DAY RECOVERY/ SHREVEPORT 6240 GREENWOOD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71119 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549825 | Andrea Lekesha Brown | Case Manager/Care Coordinator | 3518 Milky Way, Shreveport, LA 71119 | 2019-10-11 |
| 1003380213 | Eiyana Middleton | Case Manager/Care Coordinator | 5720 S Lakeshore Dr Apt 1711, Shreveport, LA 71119 | 2019-01-22 |
| 1508341264 | Cassandra Marshall | Case Manager/Care Coordinator | 5905 Candlewood, Shreveport, LA 71119 | 2018-09-28 |
| 1184125734 | Shunda Huff | Case Manager/Care Coordinator | 5636 S Lakeshore Dr Apt 632, Shreveport, LA 71119 | 2018-02-27 |
| 1093239162 | Nicole Devona Wahsington | Counselor | 2811 Metal Street, Shreveport, LA 71119 | 2017-07-31 |
| 1396266318 | Cynthia M Thomas | Driver | 6407 Santa Monica Blvd., Shreveport, LA 71119 | 2017-06-29 |
| 1154861771 | Allan Thomas | Case Manager/Care Coordinator | 3205 Linda St, Shreveport, LA 71119 | 2017-03-01 |
| 1366984312 | Demetria Carter | Counselor | 4164 Mcmichael Ave, Shreveport, LA 71119 | 2016-11-08 |
| 1033667712 | Mary Craig | Case Manager/Care Coordinator | 6215 Border Ln, Shreveport, LA 71119 | 2016-09-12 |
| 1629427331 | Donette Scroggins | Case Manager/Care Coordinator | 6605 Venus Dr, Shreveport, LA 71119 | 2016-06-03 |
| Find all providers in zip 71119 | ||||
| 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 |
| 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 |
| 1871786137 | John Philip Epling | Counselor | 2303 Line Ave, Shreveport, LA 71104-2130 | 2007-08-21 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71119 |
Please comment or provide details below to improve the information on JESSE FALLIS.
| 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.