Department of Health & Hospitals

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

License

105 Issued in LA

Legal business name

DEPARTMENT OF HEALTH & HOSPITALS

Doing business as

Shreveport Behavioral Health Clinic

Practice address

1310 North Hearne Ave.
Shreveport, LA 71107

Phone

(318) 676-5111

Fax

(318) 676-5021

NPI assigned

Jan 25, 2007

Last updated

Jul 30, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Allie D. Allen

Title

Dir. of Operations

Phone

(318) 676-5160

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Shreveport Behavioral Health Clinic Doing business as

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Monica V Bailes, RN

  • Registered Nurse
  • Shreveport, LA
  • NPI 1922377720
  NPD (past)
• France-Claire Christiane Hebert

  • Professional Counselor
  • Shreveport, LA
  • NPI 1619240132
  NPD (past)
• Sam Anthony Medica, L.P.C.

  • Social Worker
  • Shreveport, LA
  • NPI 1942585609
  NPD (past)
• Linda Anderson Pivont, LAC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
  • NPI 1457623530

  Mental Health (Including Community Mental Health Center)

  NPD (past)
• Dennis Ray Richardson

  • Registered Nurse
  • Shreveport, LA
  • NPI 1669756896
  NPD (past)
• Della Edwards Wills, LCSW

  • Social Worker
  • Shreveport, LA
  • NPI 1063611838
  NPD (past)

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1215083332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7904",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711377904",
            "telephone_number": "318-676-5111",
            "fax_number": "318-676-5021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 NORTH HEARNE AVE.",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71107",
            "telephone_number": "318-676-5111",
            "fax_number": "318-676-5021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH & HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ALLIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DIR. OF OPERATIONS",
        "authorized_official_telephone_number": "318-676-5160",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710083",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shreveport Behavioral Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Patrick Dennis
• Stephanie Dennison
• Ebony Dent
• Dental Health Clinic, Inc.
• Department of Health & Hospital
• Department of Health & Hospitals (Shreveport Behavioral Health Clinic - Child & Adolescent)
• Department of Health and Hospitals (Pines Treatment Center)
• Department of Health and Hospitals
• Dependable Care Services
• Allison Louise Derise, MD

• Mental Health Clinic/Center (Including Community Mental Health Center) in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.