WK Behavioral Health Services

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

WK BEHAVIORAL HEALTH SERVICES

Practice address

2510 Bert Kouns Industrial Loop
Shreveport, LA 71118-3119

Phone

(318) 212-5200

Fax

(318) 212-5595

NPI assigned

Aug 8, 2008

Last updated

Jun 8, 2012By 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

Greg J. Gavin

Title

Network Administrator

Phone

(318) 212-4232

Specialties & licenses 1

Addresses

Other identifiers 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572

  Member Of

  NPD member

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

{
    "created_epoch": "1218153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339113600000",
    "number": "1295981363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 LOUISIANA AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711013910",
            "telephone_number": "318-212-8574",
            "fax_number": "318-212-4153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BERT KOUNS INDUSTRIAL LOOP",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183119",
            "telephone_number": "318-212-5200",
            "fax_number": "318-212-5595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WK BEHAVIORAL HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-08",
        "last_updated": "2012-06-08",
        "status": "A",
        "authorized_official_last_name": "GAVIN",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "NETWORK ADMINISTRATOR",
        "authorized_official_telephone_number": "318-212-4232"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1189197",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• WK Advanced Cardiac Imaging
• WK Advanced Laparoscopic and Robotic Surgery Specialists
• WK Advanced Surgery Center
• WK Allergy Asthma & Immunology Center
• WK Ark-la-Tex Neonatology
• WK Breast Health & Surgical Center
• WK Care for Kids Clinic
• WK Center for Endocrinology and Diabetes
• WK Center for Neurosurgery at Pierremont
• WK Center for Pediatric Gastroenterology

• Psychiatry Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Psychiatry Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2012; 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.