| Jacquelyn Kirby Counseling & Consulting, Llc | |
|
2020 E 70th St Ste 301 Shreveport LA 71105-5332 | |
| (318) 564-2493 | |
| (318) 300-3983 |
| Full Name | Jacquelyn Kirby Counseling & Consulting, Llc |
|---|---|
| Speciality | Counselor |
| Location | 2020 E 70th St Ste 301, Shreveport, Louisiana |
| Authorized Official Name and Position | Jacquelyn Kirby (COUNSELOR/OWNER) |
| Authorized Official Contact | 3185642493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jacquelyn Kirby Counseling & Consulting, Llc 2020 E 70th St Ste 301 Shreveport LA 71105-5332 Ph: (318) 564-2493 | Jacquelyn Kirby Counseling & Consulting, Llc 2020 E 70th St Ste 301 Shreveport LA 71105-5332 Ph: (318) 564-2493 |
| NPI Number | 1770017097 |
|---|---|
| Provider Enumeration Date | 04/13/2017 |
| Last Update Date | 03/17/2018 |
| Medicare PECOS PAC ID | 5395001796 |
|---|---|
| Medicare Enrollment ID | O20171116002649 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770017097 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 5034 (Louisiana) | Primary |
| Provider Name | Ruth C Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295359255 PECOS PAC ID: 9133583024 Enrollment ID: I20230911003532 |
| Provider Name | Jacquelyn Kirby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1932644085 PECOS PAC ID: 8921364324 Enrollment ID: I20240430002430 |
| Provider Name | Mary Dyas |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033664883 PECOS PAC ID: 9436599065 Enrollment ID: I20240430003427 |
| Provider Name | Bridget Lanette Worsham |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376043943 PECOS PAC ID: 7911348073 Enrollment ID: I20240507004483 |
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