BROOKYS HAVEN (NPI# 1790283638) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790283638 |
| Entity Type | Organization |
| Organization Name | BROOKYS HAVEN |
| Other Organization Name | BROOKYS HAVEN |
| Practice Address |
217 Jones St Shreveport LA 71101-4021 |
| Practice Telephone | 3184231367 |
| Practice Fax Number | 3182163380 |
| Mailing Telephone | 3184231367 |
| Mailing Fax Number | 3182163380 |
| Enumeration Date | 2018-01-25 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | DIANE WILLIAMS (OWNER) |
| Authorized Official Telephone | 3184231367 |
| Is Organization Subpart | Y |
| Parent Organization Name | BROOKYS HAVEN |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 101Y00000X | LA | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
101YM0800X | LA | Behavioral Health & Social Service Providers |
| N | 251E00000X | Home Health | 101YM0800X | LA | Agencies |
| N | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
103TH0004X | LA | Ambulatory Health Care Facilities |
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
101Y00000X | LA | Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Brookys Haven | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104303411 | Brookys Haven | Hospice Care, Community Based | 217 Jones St Apt 215, Shreveport, LA 71101-4060 | 2018-07-20 |
| Street Address |
217 JONES ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786502 | Erik Rasmussen | Counselor | 670 Albemarle Dr Ste 700, Shreveport, LA 71106-5946 | 2020-09-25 |
| 1043842750 | Creative Community Counseling LLC | Counselor | 2920 Knight St Ste 131, Shreveport, LA 71105-2412 | 2020-02-11 |
| 1477191591 | Keona Chequise Kidd | Counselor | 2829 Dunlap St, Shreveport, LA 71103-2244 | 2019-12-19 |
| 1336781632 | A New Beginning Counseling Services, LLC | Counselor | 9441 Oleander Dr, Shreveport, LA 71118-4008 | 2019-10-08 |
| 1841840311 | Theresa Davidson Snow | Counselor | 820 Jordan St Ste 510w, Shreveport, LA 71101-4526 | 2019-09-17 |
| 1962057737 | Mariana Penny | Counselor | 152 E College St, Shreveport, LA 71104-2510 | 2019-08-07 |
| 1528622818 | Kendal Redel | Counselor | 10011 Hanover Dr, Shreveport, LA 71115-3430 | 2019-04-23 |
| 1962960351 | Brandon Lewis-graham | Counselor | 3201 Knight St Apt 2206, Shreveport, LA 71105-2749 | 2019-03-05 |
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1659840312 | Donna Brown Franks | Counselor | 236 E Gregg St, Shreveport, LA 71104-5119 | 2018-11-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on BROOKYS HAVEN.
| 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.