BEHAVIORAL SPECIALISTS OF LA (NPI# 1801289020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801289020 |
| Entity Type | Organization |
| Organization Name | BEHAVIORAL SPECIALISTS OF LA |
| Other Organization Name | BEHAVIORAL SPECIALISTS OF LOUISIANA |
| Practice Address |
925 Olive St Shreveport LA 71104-2103 |
| Mailing Address |
925 Olive Street Shreveport LA 71104 |
| Practice Telephone | 3183003560 |
| Practice Fax Number | 3183003561 |
| Mailing Telephone | 3183003560 |
| Mailing Fax Number | 3183003561 |
| Enumeration Date | 2015-03-12 |
| Last Update Date | 2018-02-14 |
| Authorized Official Name | AMY C BAMBURG (COO/AGENT) |
| Authorized Official Telephone | 3184424498 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103K00000X | Behavioral Analyst | LA | Behavioral Health & Social Service Providers | |
| N | 252Y00000X | Early Intervention Provider Agency | Agencies | ||
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 2384066 | 05 |
| Other Name | Type Code |
|---|---|
| Behavioral Specialists of Louisiana | Doing Business As Name - Organization |
| Street Address |
925 OLIVE ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71104-2103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710406194 | Alysha Brumfield | Behavioral Analyst | 925 Olive St, Shreveport, LA 71104-2103 | 2017-09-16 |
| 1578082699 | Sarah Stratton Harlan | Counselor | 925 Olive St, Shreveport, LA 71104-2103 | 2017-09-11 |
| 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 | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518267889 | Jeanne Street, Phd, Appc | Psychologist | 610 Herndon Ave., Shreveport, LA 71101 | 2010-11-02 |
| 1508055187 | Wendi Leigh Johnson Laborde | Psychologist | 2620 Centenary Blvd Ste 120, Shreveport, LA 71104-3349 | 2007-10-18 |
| 1548452832 | Gerald Kenneth Baker | Psychologist | 702 Kings Hwy, Shreveport, LA 71104-4332 | 2007-08-10 |
| 1033273107 | Jeanne Street | Psychologist | 610 Herndon Ave, Shreveport, LA 71101 | 2006-12-21 |
| 1700983251 | Milton Rhea | Psychologist | 510 E. Stoner Ave, Shreveport, LA 71101 | 2006-09-19 |
| 1730168139 | Alan Lee Rogers | Psychologist | 257 Atkins Ave, Shreveport, LA 71104-4537 | 2006-01-13 |
| 1316577141 | Jennifer L Russell, Psychologist, LLC | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2020-01-21 |
| 1215309620 | Sarah Watts Drummond | Psychologist | 707 Southfield Rd, Shreveport, LA 71106-2219 | 2015-10-24 |
| 1558789701 | Mark Garcia | Psychologist | 2620 Centenary Blvd, Bldg. #3, Suite 207, Shreveport, LA 71104-3356 | 2014-04-04 |
| 1972947034 | Steven D Abney | Psychologist | 1811 E Bert Kouns Industrial Loop, Suite 300, Shreveport, LA 71105-5740 | 2013-04-19 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71104 |
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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.