Jerrie Miles Booker

Individual provider Active NPI Mental Health Counselor · Baker, LA

NPI 1407513567 · NPPES record last updated Nov 25, 2024

Key facts

NPI
1407513567
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
1365 (LA)
Practice address
13910 Alba Dr
Baker, LA 70714-4616
Phone
(225) 931-0630
NPI assigned
Nov 23, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101YM0800X 1365 LA Yes

Addresses

Primary practice location

13910 Alba Dr
Baker, LA 70714-4616

Mailing address

9403 Mansfield Rd
Shreveport, LA 71118-3815
Phone (318) 861-8938

Other practice location 1

3084 Westfork Dr Ste C
Baton Rouge, LA 70816-2254
Phone (225) 296-6083

Other providers in Baker, LA

All providers in Baker, LA · Mental Health Counselor in Louisiana

Sources for this page

Verify at the official NPI Registry.