Individual provider Active NPI

Anita L Marshall

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1124757018
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
9089 Issued in LA
Practice address
6009 Financial PLZ Ste 102
Shreveport, LA 71129-2615
Phone
(318) 828-1455
NPI assigned
Jun 7, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9089 LA
Professional Counselor 101YP2500X 9089 LA Primary

Addresses

Primary practice location

6009 Financial PLZ Ste 102
Shreveport, LA 71129-2615

Mailing address

10466 Meadowview Dr
Keithville, LA 71047-9562
Phone (318) 453-1177

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

LicenseStateTypeSpecialty
9089LAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mind Rehabilitation and Resource Center, Inc CurrentSince Jul 9, 2023 Accepting new patients
Volunteers of America of North Louisiana PastSince Apr 1, 2023 Accepting new patients

Locations

6009 Financial Plz
Ste 102
Shreveport, LA 71129
Phone (318) 828-1455

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1124757018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10466 MEADOWVIEW DR",
            "city": "KEITHVILLE",
            "state": "LA",
            "postal_code": "710479562",
            "telephone_number": "318-453-1177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6009 FINANCIAL PLZ STE 102",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711292615",
            "telephone_number": "318-828-1455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL",
        "first_name": "ANITA",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-07",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "9089",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "9089",
            "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 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.