TRACY JEROME ANDERSON (NPI# 1962914424) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962914424 |
| Entity Type | Individual |
| Full Name | TRACY JEROME ANDERSON |
| Practice Address |
543 Stoner Ave Shreveport LA 71101-4122 |
| Mailing Address |
8526 Elmview Pl Shreveport LA 71108-5704 |
| Practice Telephone | 3186739901 |
| Practice Fax Number | 3186739904 |
| Mailing Telephone | 3185194551 |
| Enumeration Date | 2017-10-24 |
| Last Update Date | 2017-10-24 |
| Gender Code | M |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1147664 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126512 | Tracy L. Anderson | Licensed Practical Nurse | 14340 Castlewood St, Waverly, NE 68462-1580 | 2020-08-25 |
| 1710527718 | Tracy Anderson | Counselor | 11 Ne 3rd St, Washington, IN 47501-2903 | 2020-01-08 |
| 1083272504 | Tracy T Anderson | Hearing Instrument Specialist | 2725 S I 35 Service Rd, Moore, OK 73160-2715 | 2019-05-30 |
| 1821652777 | Tracy Anderson | Doula | 5366 Cooper St, Detroit, MI 48213-3075 | 2019-04-25 |
| 1568913218 | Tracy Anderson | Community/Behavioral Health | 5 Norfolk Towne St, Southfield, MI 48075-3464 | 2016-10-18 |
| 1205232063 | Tracy Lynn Anderson | Contractor | 704 E State St, Albany, WI 53502-9533 | 2014-11-06 |
| 1235431685 | Tracy Anderson | Social Worker | 1490 East Main St., Columbus, OH 43205 | 2010-11-17 |
| 1285958504 | Tracy M Anderson | Speech-Language Pathologist | 1012 Tabor Pl, Utica, NY 13502-3642 | 2010-03-15 |
| 1568595106 | Tracy Bert Anderson | Social Worker | 5689 S Redwood Rd # 30, Salt Lake City, UT 84123-5322 | 2007-03-13 |
| 1710491113 | Tracy Anderson | Health Educator | 401 Bow St, Elkton, MD 21921-5501 | 2017-11-21 |
| Street Address |
543 STONER AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396118675 | Colbelita Thomas | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2015-11-09 |
| 1912520560 | Lakayla Whitaker | Case Manager/Care Coordinator | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2020-05-18 |
| 1053958389 | Aretha L Hall | Case Manager/Care Coordinator | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2019-12-05 |
| 1508407891 | Jonathan Clint Platr | Case Manager/Care Coordinator | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2019-10-08 |
| 1528619962 | Lyric White | Case Manager/Care Coordinator | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2019-09-26 |
| 1114586120 | Angel Allyson Adams Burrell | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2019-06-12 |
| 1770053910 | Carla C Mitchell | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2018-11-30 |
| 1821587197 | Tampa Yvette Gipson | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2018-05-02 |
| 1548760952 | Latrishia Gant Jackson | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2018-02-13 |
| 1962902387 | Stacey Washington | Counselor | 543 Stoner Ave, Shreveport, LA 71101-4122 | 2018-02-13 |
| Find all providers in the same location | ||||
| 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 TRACY JEROME ANDERSON.
| 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.