Active NPI
Terri Green-Anderson, LMSW, LAC
- Clinical Social Worker
- Shreveport, LA
National Provider Identifier
1417987082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4833
- Practice address
- 1310 N Hearne Ave
Shreveport, LA 71107-6516 - Phone
- (318) 676-5111
- Fax
- (318) 676-5126
- NPI assigned
- Jul 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4833 | LA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1075 | LA |
Addresses
Primary practice location
1310 N Hearne Ave
Shreveport, LA 71107-6516
Mailing address
1310 N Hearne Ave
Shreveport, LA 71107-6516
Phone (318) 676-5111
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4833 | LA | MD | Mental Health Counselor |
| 1075 | LA | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1529107200000",
"number": "1417987082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1310 N HEARNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076516",
"telephone_number": "318-676-5111",
"fax_number": "318-676-5126"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 N HEARNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076516",
"telephone_number": "318-676-5111",
"fax_number": "318-676-5126"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN-ANDERSON",
"first_name": "TERRI",
"name_prefix": "Ms.",
"credential": "LMSW, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-03",
"last_updated": "2018-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "LA",
"license": "4833",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "1075",
"primary": false
}
],
"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 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.