Active NPI
Shade Chantel Rodriguez, CIT
- Addiction (Substance Use Disorder) Counselor
- West Monroe, LA
National Provider Identifier
1114792348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 5718
- Practice address
- 5542 Whites Ferry Rd Lot 4
West Monroe, LA 71291-8839 - Phone
- (318) 614-7826
- NPI assigned
- Nov 17, 2023
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 5718 | LA | Primary |
Addresses
Primary practice location
5542 Whites Ferry Rd Lot 4
West Monroe, LA 71291-8839
Mailing address
2321 US-80
Monroe, LA 71203
Phone (318) 600-3333
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 |
|---|---|---|---|
| 5718 | LA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sullivan Management LLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Monroe, LA
- NPI 1811721046
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700179200000",
"number": "1114792348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2321 US-80",
"city": "MONROE",
"state": "LA",
"postal_code": "71203",
"telephone_number": "318-600-3333"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5542 WHITES FERRY RD LOT 4",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712918839",
"telephone_number": "318-614-7826"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RODRIGUEZ",
"first_name": "SHADE",
"middle_name": "CHANTEL",
"credential": "CIT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-11-17",
"last_updated": "2023-11-17",
"certification_date": "2023-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "5718",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.