Individual provider Active NPI

Sandra Smith Fargerson, M.S., L.P.C., N.C.C.

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1407998370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3746 Issued in LA
Practice address
900 Pierremont Rd
Suite 217
Shreveport, LA 71106-2044
Phone
(318) 868-1165
Fax
(318) 868-1180
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3746 LA Primary

Addresses

Primary practice location

900 Pierremont Rd
Suite 217
Shreveport, LA 71106-2044

Mailing address

104 Devereaux Dr
Bossier City, LA 71111-6128
Phone (318) 742-3895

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
3746LAMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407998370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 DEVEREAUX DR",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711116128",
            "telephone_number": "318-742-3895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 PIERREMONT RD",
            "address_2": "SUITE 217",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711062044",
            "telephone_number": "318-868-1165",
            "fax_number": "318-868-1180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARGERSON",
        "first_name": "SANDRA",
        "middle_name": "SMITH",
        "credential": "M.S., L.P.C., N.C.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "3746",
            "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 Jul 8, 2007; 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.