Active NPI
Ebony Espinosa, LPC
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1013427756
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 7757
- Practice address
- 151 Freestate Blvd
Shreveport, LA 71107-6535 - Phone
- (318) 226-5990
- Fax
- (318) 675-3711
- NPI assigned
- Oct 9, 2017
- Last updated
- Oct 5, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7757 | LA | Primary |
Addresses
Primary practice location
151 Freestate Blvd
Shreveport, LA 71107-6535
Mailing address
1434 Hawn Ave
Shreveport, LA 71107-6508
Phone (318) 617-8063
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7757 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7757 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CBS Act Center LLC | Mental Health | Current | Accepting new patients |
Locations
151 Freestate Blvd
Shreveport, LA 71107
Phone (318) 226-5990
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1507507200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1664928000000",
"number": "1013427756",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1434 HAWN AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076508",
"telephone_number": "318-617-8063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 FREESTATE BLVD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076535",
"telephone_number": "318-226-5990",
"fax_number": "318-675-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESPINOSA",
"first_name": "EBONY",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-10-09",
"last_updated": "2022-10-05",
"certification_date": "2022-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "7757",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7757",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.