CRYSTAL DAVIS (NPI# 1801268313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801268313 |
| Entity Type | Individual |
| Full Name | CRYSTAL DAVIS |
| Practice Address |
2210 Line Ave Ste 207 Shreveport LA 71104-2134 |
| Practice Telephone | 3186751112 |
| Practice Fax Number | 8663079980 |
| Mailing Telephone | 3186751112 |
| Mailing Fax Number | 8663079980 |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-10-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2210 Line Ave Ste 207, Shreveport, LA 711042134 | 3186751112 | 8663079980 |
| 3018 Old Minden Rd Ste 1117, Bossier City, LA 711122497 | 3187461935 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669963708 | Crystal Leigh Davis | Counselor | 43 Leopard Rd Ste 203, Paoli, PA 19301-1552 | 2018-05-24 |
| 1144731365 | Crystal Dawn Davis | Pharmacist | 3501 36th Ave Nw, Norman, OK 73072-2429 | 2017-10-15 |
| 1558750349 | Crystal Davis | Occupational Therapy Assistant | 6932 County Road 1215, Flint, TX 75762-9176 | 2015-01-15 |
| 1154738573 | Crystal Davis | Registered Nurse | 20129 Tracey St, Detroit, MI 48235-1570 | 2014-07-17 |
| 1427300516 | Crystal Mary Davis | Counselor | 15 Adna Rd, Bristol, CT 06010-2719 | 2012-10-12 |
| 1184802712 | Crystal Renee Davis | Physician Assistant | 4963 W. 135th St, Leawood, KS 66224 | 2008-02-06 |
| 1417002064 | Crystal L Davis | Massage Therapist | 139 1st Ave. Sw, Castle Rock, WA 98611 | 2007-01-24 |
| 1518501741 | Crystal Davis | Behavior Technician | 6200 Virginia Pkwy, Mckinney, TX 75071-5504 | 2019-10-31 |
| 1033681523 | Crystal Nichole Davis | Dental Assistant | 7525 N Cedar Ave Ste 105, Fresno, CA 93720-2698 | 2018-12-20 |
| 1801379631 | Crystal Davis | Counselor | 2434 S Eason Blvd, Tupelo, MS 38804-6942 | 2018-09-07 |
| Street Address |
2210 LINE AVE STE 207 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-2134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790310704 | Carolyn Louise Baker | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2020-03-10 |
| 1639703093 | John Collins | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2020-02-25 |
| 1295367969 | Santrica Pope | Social Worker | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2020-02-10 |
| 1548807787 | Tony Gipson | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2019-12-06 |
| 1952944530 | Laporscha Terrell | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2019-10-25 |
| 1881249167 | Stephanie Marsiglia Entwistle | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, 2210 Line Ave Ste 207, Shreveport, LA 71104-7110 | 2019-08-05 |
| 1649830134 | Jonathan Deleon Mitchell | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2019-06-17 |
| 1215403183 | Ifeyinwa R Mbadugha | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2018-10-18 |
| 1285113316 | Yura Haze Wright | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2018-08-09 |
| 1841779956 | Christopher Dewayne Handy | Case Manager/Care Coordinator | 2210 Line Ave Ste 207, Shreveport, LA 71104-2134 | 2018-08-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326582263 | Dana Jackson | Counselor | 2425 Youree Drive, Shreveport, LA 71104 | 2016-12-12 |
| 1154772929 | Belena Cawthorne | Case Manager/Care Coordinator | 2040 Southern Ave, Shreveport, LA 71104 | 2016-06-23 |
| 1437505286 | Courtney Espenan | Counselor | 3825 Gilbert Dr Ste 124, Shreveport, LA 71104 | 2016-05-11 |
| 1215390497 | Joshua Mitchell | Counselor | 1106 Dalzell Street, Shreveport, LA 71104 | 2016-04-04 |
| 1699135426 | Amy Lutricia Krohn | Counselor | 1041 Dalzell St, Shreveport, LA 71104 | 2016-03-07 |
| 1225497779 | Annie Redding II | Counselor | 2525 Youree Dr Suite 110, Shreveport, LA 71104 | 2016-02-12 |
| 1891152328 | Council On Alcoholism and Drug Abuse of Northwest Louisiana | Community/Behavioral Health | 2000 Fairfield Ave, Shreveport, LA 71104 | 2016-01-28 |
| 1922465731 | Marteze Singleton | Case Manager/Care Coordinator | 2525 Youree Dr Ste 10, Shreveport, LA 71104 | 2016-01-25 |
| 1891160297 | Damara Mora | Counselor | 2620 Centenary Blvd Bldg3 Ste 312, Shreveport, LA 71104 | 2015-12-10 |
| 1962876250 | Chastity Shermaine Graham | Counselor | 2620 Centenary Blvd Ste 312, Shreveport, LA 71104 | 2015-11-24 |
| Find all providers in zip 71104 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360887 | Halena Jones | Case Manager/Care Coordinator | 9409 Chaparral Ln, Shreveport, LA 71118-4337 | 2020-09-11 |
| 1598376196 | Michaela Nicole Bradley | Case Manager/Care Coordinator | 10021 Stratmore Cir, Shreveport, LA 71115-3416 | 2020-08-17 |
| 1619585791 | Kimberly Bissell | Case Manager/Care Coordinator | 7505 Pines Rd Ste 1115, Shreveport, LA 71129-3900 | 2020-07-15 |
| 1902414170 | Unique Lashae Lister | Case Manager/Care Coordinator | 2611 Corbitt St, Shreveport, LA 71108-2805 | 2020-07-14 |
| 1407474828 | Angela Harris | Case Manager/Care Coordinator | 1111 W 70th St Apt 93, Shreveport, LA 71106-3558 | 2020-07-13 |
| 1669096921 | Ryan Barham | Case Manager/Care Coordinator | 824 Oneonta St, Shreveport, LA 71106-1130 | 2020-06-02 |
| 1922621085 | Julian White | Case Manager/Care Coordinator | 8529 Grover Pl, Shreveport, LA 71115-2707 | 2020-05-24 |
| 1396368817 | Shannon Marie Cannon | Case Manager/Care Coordinator | 1543 Summers St, Shreveport, LA 71108-3131 | 2020-05-19 |
| 1730701954 | Brianna Mason | Case Manager/Care Coordinator | 1533 Marshall St, Shreveport, LA 71101-3941 | 2020-05-11 |
| 1295355238 | Angela Rice | Case Manager/Care Coordinator | 2704 Frostwood Dr, Shreveport, LA 71108-5524 | 2020-04-20 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
Please comment or provide details below to improve the information on CRYSTAL DAVIS.
| 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.