Individual provider Active NPI

Michele Leigh Brown, CIT

  • Addiction (Substance Use Disorder) Counselor
  • Shreveport, LA
National Provider Identifier
1689331142
Registry record updated Nov 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
5302 Issued in LA
Practice address
2419 Southern Ave
Shreveport, LA 71104-2969
Phone
(318) 505-7001
Fax
(318) 227-1472
NPI assigned
Nov 19, 2021
Last updated
Nov 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5302 LA Primary

Addresses

Primary practice location

2419 Southern Ave
Shreveport, LA 71104-2969

Mailing address

2419 Southern Ave
Shreveport, LA 71104-2969
Phone (318) 505-7001

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

LicenseStateTypeSpecialty
5302LAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Recovery Center Addiction (Substance Use Disorder) CurrentSince Nov 21, 2021 Accepting new patients

Locations

2419 Southern Ave
Shreveport, LA 71104
Phone (318) 227-1475

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1637280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637280000000",
    "number": "1689331142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 SOUTHERN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042969",
            "telephone_number": "318-505-7001",
            "fax_number": "318-227-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2419 SOUTHERN AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042969",
            "telephone_number": "318-505-7001",
            "fax_number": "318-227-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "MICHELE",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "CIT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-19",
        "last_updated": "2021-11-19",
        "certification_date": "2021-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "5302",
            "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 Nov 19, 2021; 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.