Active NPI
Khairah Ali-Allen
- Mental Health Counselor
- Shreveport, LA
National Provider Identifier
1124584024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 3341 Youree Dr
Shreveport, LA 71105-2149 - Phone
- (318) 219-4167
- NPI assigned
- Feb 15, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
3341 Youree Dr
Shreveport, LA 71105-2149
Mailing address
512 Barrington Dr BLDG E
Bossier City, LA 71112-3186
Phone (202) 222-8486
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 232799679 | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1550188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550188800000",
"number": "1124584024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 BARRINGTON DR BLDG E",
"city": "BOSSIER CITY",
"state": "LA",
"postal_code": "711123186",
"telephone_number": "202-222-8486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3341 YOUREE DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711052149",
"telephone_number": "318-219-4167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALI-ALLEN",
"first_name": "KHAIRAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-02-15",
"last_updated": "2019-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "232799679",
"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 Feb 15, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.