NPIMap

Organization Active NPI

Council for Advancement of Social Service and Education

Doing business as CHI - Caddo

  • General Practice Dentistry
  • Shreveport, LA
National Provider Identifier
1447337787
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3665 Issued in LA
Legal business name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Doing business as
CHI - Caddo
Practice address
2120 Bert Kouns Industrial Loop Ste B
Shreveport, LA 71118-3351
Phone
(318) 688-3350
Fax
(318) 688-3655
NPI assigned
Nov 1, 2006
Last updated
Oct 18, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Mrs. Mary Madden Chumley
Title
Executive Director
Phone
(318) 688-3350

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU
Social Worker 104100000X NU
General Practice Dentistry 1223G0001X 3665 LA Primary
General Practice Physician 208D00000X NU

Addresses

Primary practice location

2120 Bert Kouns Industrial Loop Ste B
Shreveport, LA 71118-3351

Mailing address

2120 Bert Kouns Industrial Loop Ste a
Shreveport, LA 71118-3351
Phone (318) 688-3350

Other identifiers 3

IdentifierTypeStateIssuer
1452769MedicaidLA
455678OtherUNITED CONCORDIA INS.
C8303OtherLABLUE CROSS/BLUE SHIELD LA

Other names 1

  • CHI - Caddo Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Council for the Advancement of Social Servies and Education10 organizations share this tax ID, including this one
Part of
Council for the Advancement of Social Servies and Education

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2120 Bert Kouns Industrial Loop
Ste B
Shreveport, LA 71118
Phone (314) 687-4156

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1447337787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP STE A",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183351",
            "telephone_number": "318-688-3350",
            "fax_number": "318-688-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 BERT KOUNS INDUSTRIAL LOOP STE B",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711183351",
            "telephone_number": "318-688-3350",
            "fax_number": "318-688-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION",
        "enumeration_date": "2006-11-01",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "CHUMLEY",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "MADDEN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "318-688-3350",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "3665",
            "primary": true
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452769",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INS.",
            "identifier": "455678",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD LA",
            "identifier": "C8303",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHI - Caddo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CHI - Caddo",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 18, 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.