NPIMap

Organization Active NPI

Street Outreach Solutions,LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
National Provider Identifier
1669918199
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
STREET OUTREACH SOLUTIONS,LLC
Practice address
2715 Mackey PL Ste 119
Shreveport, LA 71118-2527
Phone
(318) 393-5407
NPI assigned
Jan 8, 2017
Last updated
Jun 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Authorized official

Name
Mrs. Mar'Dosha PeekNPI 1144690363
Title
Chief Executive Officer
Phone
(318) 771-7707

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

2715 Mackey PL Ste 119
Shreveport, LA 71118-2527

Mailing address

2715 Mackey PL Ste 119
Shreveport, LA 71118-2527
Phone (318) 771-7707

Other names 1

  • n/a Former legal business name

National Provider Directory

National Provider Directory

Locations

2715 Mackey Pl
Ste 119
Shreveport, LA 71118
Phone (318) 393-5407

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1483833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687478400000",
    "number": "1669918199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2715 MACKEY PL STE 119",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182527",
            "telephone_number": "318-771-7707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2715 MACKEY PL STE 119",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182527",
            "telephone_number": "318-393-5407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STREET OUTREACH SOLUTIONS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-08",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A",
        "authorized_official_last_name": "PEEK",
        "authorized_official_first_name": "MAR'DOSHA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "318-771-7707",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "n/a",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "n/a",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 23, 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.