Equanimity Mental Health & Wellness, LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

EQUANIMITY MENTAL HEALTH & WELLNESS, LLC

Practice address

2000 Creswell Ave
Shreveport, LA 71104-2202

Phone

(318) 313-2944

NPI assigned

Dec 9, 2022

Last updated

Dec 13, 2022By 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

Larry David Allan, NP

Title

Owner

Phone

(318) 313-2944

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Locations

Practitioners 1

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.

• Larry David Allen Jr., APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Shreveport, LA
  • NPI 1942660287
  Medicare reassignment NPD

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670889600000",
    "number": "1316658438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 ISLAND PARK BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054737",
            "telephone_number": "318-313-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CRESWELL AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042202",
            "telephone_number": "318-313-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUANIMITY MENTAL HEALTH & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-09",
        "last_updated": "2022-12-13",
        "certification_date": "2022-12-13",
        "status": "A",
        "authorized_official_last_name": "ALLAN",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-313-2944",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allyne Ensor
• Stephanie Marsiglia Entwistle
• Envision Counseling Services LLC
• Epic Innovations LLC
• John Philip Epling, M.D.
• Beyzanur Ergun, MD
• Clarence B. Erickson III, D.D.S.
• Eric Marc Erlewine, MPT
• Stephen Eugene Ertz, DPM
• Angel Escobedo, RN

• Psychiatric/Mental Health Nurse Practitioner in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.