Active NPI
Jack Clary Murrell Jr.
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1083503262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PLC10766
- Practice address
- 9403 Mansfield Rd
Shreveport, LA 71118-3815 - Phone
- (318) 861-8938
- NPI assigned
- Jul 1, 2025
- Sex
- Male
- 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 | PLC10766 | LA | Primary |
Addresses
Primary practice location
9403 Mansfield Rd
Shreveport, LA 71118-3815
Mailing address
9403 Mansfield Rd
Shreveport, LA 71118-3815
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 |
|---|---|---|---|
| PLC10766 | LA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1751328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751328000000",
"number": "1083503262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9403 MANSFIELD RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9403 MANSFIELD RD",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711183815",
"telephone_number": "318-861-8938"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MURRELL",
"first_name": "JACK",
"middle_name": "CLARY",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-07-01",
"last_updated": "2025-07-01",
"certification_date": "2025-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "PLC10766",
"primary": true
}
],
"identifiers": [],
"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 Jul 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.