NPIMap

Organization Active NPI

Lifenet

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Mandeville, LA
National Provider Identifier
1740539410
Registry record updated Sep 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
License
AP03867 Issued in LA
Legal business name
LIFENET
Practice address
4050 Lonesome Rd
Ste a
Mandeville, LA 70448-7085
Phone
(985) 778-9141
NPI assigned
Sep 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2012

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

Authorized official

Name
Sharissa Taylor, PHD
Title
Owner
Phone
(985) 778-9141

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X AP03867 LA Primary

Addresses

Primary practice location

4050 Lonesome Rd
Ste a
Mandeville, LA 70448-7085

Mailing address

4050 Lonesome Rd
Ste a
Mandeville, LA 70448-7085
Phone (985) 778-9141

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347235200000",
    "number": "1740539410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 LONESOME RD",
            "address_2": "STE A",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-778-9141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 LONESOME RD",
            "address_2": "STE A",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487085",
            "telephone_number": "985-778-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFENET",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-10",
        "last_updated": "2012-09-10",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SHARISSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "985-778-9141",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "LA",
            "license": "AP03867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2012; 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.