NPIMap

Organization Active NPI

CBS Act Center LLC

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1396081097
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
10334076#LUL73 Issued in LA
Legal business name
CBS ACT CENTER LLC
Practice address
151 Freestate Blvd
Shreveport, LA 71107-6535
Phone
(318) 226-5990
Fax
(318) 226-5994
NPI assigned
Dec 27, 2012
Last updated
Jun 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Authorized official

Name
Ms. Pamela Michelle Phillips, MBA
Title
Business Manager
Phone
(318) 617-5869

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X 10334076#LUL73 LA
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU
Mental Health Counselor 101YM0800X 10334076#LUL73 LA
Community/Behavioral Health Agency 251S00000X 10334076#LUL73 LA Primary

Addresses

Primary practice location

151 Freestate Blvd
Shreveport, LA 71107-6535

Mailing address

PO Box 7875
Shreveport, LA 71137-7875
Phone (318) 617-5869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161102002305 LA Part B Supplier - Clinic/Group Practice 4082992680 Receives reassigned benefits from 1 practitioner
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

1440 Hawn Ave
Shreveport, LA 71107
Phone (318) 226-5990

151 Freestate Blvd
Shreveport, LA 71107
Phone (318) 226-5990

Practitioners & affiliated clinicians

Practitioners 50

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.

View all 50

NPI Registry JSON

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

{
    "created_epoch": "1356566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687910400000",
    "number": "1396081097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7875",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711377875",
            "telephone_number": "318-617-5869",
            "fax_number": "318-226-5994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 FREESTATE BLVD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711076535",
            "telephone_number": "318-226-5990",
            "fax_number": "318-226-5994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CBS ACT CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "318-617-5869",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "LA",
            "license": "10334076#LUL73",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "10334076#LUL73",
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "LA",
            "license": "10334076#LUL73",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.