Individual provider Active NPI

Alisha Davis, LCSWW

  • Social Worker
  • Shreveport, LA
National Provider Identifier
1174773295
Registry record updated Dec 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4861 Issued in LA
Practice address
510 E Stoner Ave
Shreveport, LA 71101-4243
Phone
(318) 221-8411
NPI assigned
Sep 25, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 4861 LA
Clinical Social Worker 1041C0700X 107531 TX
Social Worker 104100000X 4861 LA Primary

Addresses

Primary practice location

510 E Stoner Ave
Shreveport, LA 71101-4243

Mailing address

510 E Stoner Ave
Shreveport, LA 71101-4243
Phone (318) 221-8411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922004032 TX Practitioner - Clinical Social Worker 3971995218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4861LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Red River Therapeutic Solutions LLC CurrentSince Apr 19, 2022 Accepting new patients

Locations

2715 Mackey Pl
Ste 135
Shreveport, LA 71118
Phone (318) 220-8423

310 W Central Texas Expy
Ste 1
Killeen, TX 76541
Phone (254) 319-0523

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.

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702944000000",
    "number": "1174773295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 E STONER AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711014243",
            "telephone_number": "318-221-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ALISHA",
        "name_prefix": "Ms.",
        "credential": "LCSWW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-25",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "4861",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "107531",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "4861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.