GRACE MBENKUM (NPI# 1609306372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609306372 |
| Entity Type | Individual |
| Full Name | GRACE MBENKUM |
| Practice Address |
809 Polk St Mansfield LA 71052-2452 |
| Mailing Address |
1500 Tina Ct Bossier City LA 71112-3639 |
| Practice Telephone | 3188715566 |
| Practice Fax Number | 3188715566 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
809 POLK ST |
| City | MANSFIELD |
| State | LA |
| Zip Code | 71052-2452 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790829646 | Cognitive Institute Incorporated | Counselor | 809 Polk St, Mansfield, LA 71052 | 2007-02-16 |
| 1053816793 | Kertrigus Lushun Thomas | Case Manager/Care Coordinator | 809 Polk St, Mansfield, LA 71052-2452 | 2018-03-26 |
| 1396247284 | Tiffany Nicole Toliver | Social Worker | 809 Polk St, Mansfield, LA 71052-2452 | 2018-03-06 |
| 1851820864 | Latitia Renee Mcdaniel | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2017-06-05 |
| 1558892323 | Lashonda Gray | Counselor | 809 Polk St, Mansfield, LA 71052 | 2017-03-23 |
| 1417406075 | Faith Alexander | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2016-09-23 |
| 1285182626 | Dominique Johnson | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2016-09-14 |
| 1861948143 | Mary James-thomas | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2016-08-28 |
| 1902266687 | Kimberly Pradia | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2016-02-24 |
| 1073971545 | Orlando Wade Mack | Counselor | 809 Polk St, Mansfield, LA 71052-2452 | 2016-01-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689186421 | Bridgette Williams | Counselor | 419 Washington Street, Mansfield, LA 71052 | 2017-11-02 |
| 1922527217 | Cherlyndria Wyatt | Counselor | 108 Hope St, Mansfield, LA 71052 | 2017-09-18 |
| 1619342433 | Stanley Cunningham | Counselor | 125 Canary Lane, Mansfield, LA 71052 | 2015-12-04 |
| 1578936480 | Comiseia Jones | Counselor | 2102 N Park Ave, Mansfield, LA 71052 | 2015-11-02 |
| 1932571023 | Elichia Bennett | Counselor | 584 Antioch Rd, Mansfield, LA 71052 | 2015-10-28 |
| 1912378597 | Angela Mcintyre | Case Manager/Care Coordinator | 162 Division St, Mansfield, LA 71052 | 2015-10-08 |
| 1144690645 | Edwina Elrod Eley | Nurse Practitioner | 7356 Highway 509, Mansfield, LA 71052 | 2015-09-28 |
| 1760746176 | Amy Melton Robbins | Occupational Therapist | 558 Turner Robbins Rd, Mansfield, LA 71052 | 2012-06-29 |
| 1811209232 | Desoto Healthcare Center Inc. | Internal Medicine | 938 Louise St, Mansfield, LA 71052 | 2010-07-14 |
| 1174786263 | Frances Jackson | Speech-Language Pathologist | 508 Rea Street, Mansfield, LA 71052 | 2008-07-08 |
| Find all providers in zip 71052 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336765734 | Katarina Alexandra Radovsky | Counselor | 792 West St Apt G106, Mansfield, MA 02048-4109 | 2020-06-22 |
| 1861046385 | Lacey Eaton | Counselor | 805 Killian Dr, Mansfield, TX 76063 | 2019-08-01 |
| 1689186421 | Bridgette Williams | Counselor | 419 Washington Street, Mansfield, LA 71052 | 2017-11-02 |
| 1922527217 | Cherlyndria Wyatt | Counselor | 108 Hope St, Mansfield, LA 71052 | 2017-09-18 |
| 1669991766 | Heather Michelle Hedges | Counselor | 8 Walker Avenue South, Mansfield, OH 44905 | 2017-09-11 |
| 1972027217 | Raiyawna Gatlin | Counselor | 419 Washington Ave, Mansfield, LA 71052-3103 | 2017-07-28 |
| 1457875932 | Derrick Francis Martin | Counselor | 1601 Nantucket Dr, Mansfield, OH 44904-2147 | 2017-07-27 |
| 1356879340 | Rachel Michelle Slack | Counselor | 751 Highway 287 N Ste 103, Mansfield, TX 76063-6604 | 2017-06-02 |
| 1134650526 | Lovia Hunter | Counselor | 317 Murphy St, Mansfield, LA 71052-4140 | 2017-03-27 |
| 1619412848 | Patricia Mcgrew | Counselor | 502 Hollyberry Dr, Mansfield, TX 76063-3640 | 2016-12-26 |
| Find all providers in MANSFIELD | ||||
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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.