| Shreveport Behavioral Health Clinic | |
|
1310 N Hearne Ave Shreveport LA 71107-6516 | |
| (318) 676-5111 | |
| (318) 676-5021 |
| Full Name | Shreveport Behavioral Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1310 N Hearne Ave, Shreveport, Louisiana |
| Authorized Official Name and Position | Carol W Robertson (ACCOUNTING SUPERVISOR) |
| Authorized Official Contact | 3188623067 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shreveport Behavioral Health Clinic 1310 N Hearne Ave Shreveport LA 71107-6516 Ph: (318) 676-5111 | Shreveport Behavioral Health Clinic 1310 N Hearne Ave Shreveport LA 71107-6516 Ph: (318) 676-5111 |
| NPI Number | 1821421686 |
|---|---|
| Provider Enumeration Date | 08/15/2013 |
| Last Update Date | 12/03/2015 |
| Medicare PECOS PAC ID | 1456580398 |
|---|---|
| Medicare Enrollment ID | O20140412000086 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821421686 | NPI | - | NPPES |
| 2203782546 | Other | LA | BEHAVIORAL HEALTH SERVICE PROVIDER |
| 1710083 | Medicaid | LA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 2203782546 (Louisiana) | Primary |
| Provider Name | Patrick T Wheat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003897208 PECOS PAC ID: 2163412669 Enrollment ID: I20040517000432 |
| Provider Name | John M Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518054881 PECOS PAC ID: 8729029384 Enrollment ID: I20050513000661 |
| Provider Name | Michael V Susano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063440105 PECOS PAC ID: 5294768040 Enrollment ID: I20050913000957 |
| Provider Name | Lalitha Alla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023188554 PECOS PAC ID: 9436210101 Enrollment ID: I20081213000014 |
| Provider Name | Robin F Hogue |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518957810 PECOS PAC ID: 8820153612 Enrollment ID: I20090211000098 |
| Provider Name | Wendy C Mcdowell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932252616 PECOS PAC ID: 3678603560 Enrollment ID: I20130503000159 |
| Provider Name | Pamela K Mcpherson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194761163 PECOS PAC ID: 1254651029 Enrollment ID: I20150519000030 |
| Provider Name | Bobby J Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699196188 PECOS PAC ID: 1951687656 Enrollment ID: I20170412001265 |
| Provider Name | Shirley D Falvey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508138074 PECOS PAC ID: 4486920352 Enrollment ID: I20171019002962 |
| Provider Name | Avis N Jackson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396309399 PECOS PAC ID: 8022441542 Enrollment ID: I20191213000929 |
| Provider Name | Anand N Bosmia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235525395 PECOS PAC ID: 8628374774 Enrollment ID: I20200727001063 |
| Provider Name | Patrick Velazquez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275114738 PECOS PAC ID: 2567869902 Enrollment ID: I20210928000179 |
| Provider Name | Karla Jones-gipson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245719483 PECOS PAC ID: 6002281078 Enrollment ID: I20230404002211 |
| 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 | Sharon R Beard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124398532 PECOS PAC ID: 7315395167 Enrollment ID: I20240116001205 |
| Provider Name | Angela C Mann |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093066508 PECOS PAC ID: 4486002185 Enrollment ID: I20240116001525 |
| Provider Name | Lashauna C Madison |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699010496 PECOS PAC ID: 2567810260 Enrollment ID: I20240122001464 |
| Provider Name | Stephanie L Bradley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1255882221 PECOS PAC ID: 5496103194 Enrollment ID: I20240122003259 |
| Provider Name | Juanita C Jones |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1013911775 PECOS PAC ID: 0648628347 Enrollment ID: I20240122003379 |
| Provider Name | Erica R Ashley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629275292 PECOS PAC ID: 7810345527 Enrollment ID: I20240123000098 |
| Provider Name | Sara L Rice |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033556261 PECOS PAC ID: 0547618258 Enrollment ID: I20240124002174 |
| Provider Name | Sarakay J Reid |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891934998 PECOS PAC ID: 1951759653 Enrollment ID: I20240125002393 |
| Provider Name | Marsha L Hayes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1124392915 PECOS PAC ID: 4789031477 Enrollment ID: I20240202003963 |
| Provider Name | Jessica N Joffrion |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831545029 PECOS PAC ID: 4082056403 Enrollment ID: I20240530000820 |
| Provider Name | Gregory Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770091480 PECOS PAC ID: 3476095928 Enrollment ID: I20240612000245 |
Cbs Counseling Center Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1406 Hawn Ave, Shreveport, LA 71107 Phone: 317-617-5869 Fax: 317-675-0226 | |
Red River Therapeutic Solutions Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2715 Mackey Pl Ste 135, Shreveport, LA 71118 Phone: 318-220-8423 Fax: 318-220-8573 | |
Roan Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1455 E Bert Kouns Industrial Loop # 102, Shreveport, LA 71105 Phone: 318-798-4444 Fax: 318-795-4748 | |
Sunshine Mental Health Counseling Service, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 Youree Dr, Bldg B Suite 426, Shreveport, LA 71104 Phone: 318-617-4385 | |
Clw Counseling, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2920 Knight St Ste 112, Shreveport, LA 71105 Phone: 318-510-0612 | |
Unshattered Counseling Services, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Texas St Ste 1050-04, Shreveport, LA 71101 Phone: 318-688-8218 | |
Travelers Counseling Agency Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Marshall St, Shreveport, LA 71101 Phone: 318-606-5105 Fax: 318-606-5908 |