Goebel, Vigen, & Associates | |
3341 Youree Dr Ste 20a Shreveport LA 71105-2149 | |
(318) 425-2000 | |
(318) 424-2601 |
Full Name | Goebel, Vigen, & Associates |
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Speciality | Psychologist |
Location | 3341 Youree Dr Ste 20a, Shreveport, Louisiana |
Authorized Official Name and Position | Kimber Fuller (OFFICE MANAGER) |
Authorized Official Contact | 3184252000 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Goebel, Vigen, & Associates 3341 Youree Dr Ste 20a Shreveport LA 71105-2149 Ph: (318) 425-2000 | Goebel, Vigen, & Associates 3341 Youree Dr Ste 20a Shreveport LA 71105-2149 Ph: (318) 425-2000 |
NPI Number | 1154951986 |
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Provider Enumeration Date | 01/21/2020 |
Last Update Date | 12/21/2020 |
Certification Date | 12/21/2020 |
Medicare PECOS PAC ID | 5890121925 |
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Medicare Enrollment ID | O20200207000854 |
Identifier | Type | State | Issuer |
---|---|---|---|
1154951986 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103TC1900X | Psychologist - Counseling | (* (Not Available)) | Secondary |
103TP0016X | Psychologist - Prescribing (medical) | (* (Not Available)) | Primary |
Provider Name | Michael Todd Lobrano |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1750761847 PECOS PAC ID: 8022327626 Enrollment ID: I20151022000242 |
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