Spectrum Rehab Services, Inc.

Primary specialty

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

Legal business name

SPECTRUM REHAB SERVICES, INC.

Practice address

30826 Linder Rd
Denham Springs, LA 70726-8507

Phone

(225) 665-7878

Fax

(225) 665-7856

NPI assigned

Jan 17, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Kyle Jacob

Title

Coo

Phone

(318) 746-0420

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 104

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Bourgeois Abed, LCSW-BACS

  • Clinical Social Worker
  • Denham Springs, LA
  • NPI 1407225303
  NPD (past)
• Amber Ackermann, MS, LPC

  • Counselor
  • Baton Rouge, LA
  • NPI 1467997908
  NPD (past)
• Dymond Ashford

  • Counselor
  • Denham Springs, LA
  • NPI 1184079048
  NPD (past)
• Melissa Ann Averett, LPC

  • Counselor
  • Denham Springs, LA
  • NPI 1861861767
  NPD (past)
• Lashanda Batiste-Collins, LPC

  • Professional Counselor
  • New Roads, LA
  • NPI 1952770562
  NPD (past)
• Mindy Ann Berteau

  • Case Manager/Care Coordinator
  • Denham Springs, LA
  • NPI 1437504495
  NPD (past)
• McCall Blank

  • Counselor
  • Denham Springs, LA
  • NPI 1740632124
  NPD (past)
• Shanequa Dejon Bridges

  • Professional Counselor
  • Shreveport, LA
  • NPI 1144743600
  NPD (past)
• Stephen Bridgewater

  • Counselor
  • Denham Springs, LA
  • NPI 1265960850
  NPD (past)
• Cher Broussard

  • Social Worker
  • Denham Springs, LA
  • NPI 1336510858
  NPD (past)
• Shawanda Brown, LPC

  • Mental Health Counselor
  • Baton Rouge, LA
  • NPI 1316655087
  NPD (past)
• Shantele Angela Butler, LPC-S

  • Professional Counselor
  • Clinton, LA
  • NPI 1033588892
  NPD (past)

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690156800000",
    "number": "1356493530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30826 LINDER RD",
            "city": "DENHAM SPRINGS",
            "state": "LA",
            "postal_code": "707268507",
            "telephone_number": "225-665-7878",
            "fax_number": "225-665-7856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECTRUM REHAB SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-17",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "318-746-0420",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "1548839",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1989151",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southeast Community Health Systems
• Southern DME Co, LLC
• Southern DME, LLC
• Rowyn Spears
• Tanquetra Chenique Spears, LMSW
• Robert Spence
• St Charles Specialty Rehabilitation Hospital LLC
• Donald Max St. Angelo Jr., DDS
• Dara St. Pierre, SLP
• Lanny Elizabeth Stanly

• All providers in Denham Springs, LA
• 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 24, 2023; 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.