NPIMap

Organization Active NPI

Pelican Bayou Counseling Agency Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shreveport, LA
National Provider Identifier
1760852511
Registry record updated Jun 26, 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
PELICAN BAYOU COUNSELING AGENCY INC.
Practice address
9403 Mansfield Road
Shreveport, LA 71118-2119
Phone
(318) 861-8938
NPI assigned
Oct 5, 2015
Last updated
Jun 26, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2023

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

Authorized official

Name
Brittney Cummings
Title
Owner
Phone
(318) 861-8938

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Community/Behavioral Health Agency 251S00000X NU

Addresses

Primary practice location

9403 Mansfield Road
Shreveport, LA 71118-2119

Mailing address

9403 Mansfield Road
Shreveport, LA 71118-2119
Phone (318) 861-8938

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687737600000",
    "number": "1760852511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9403 MANSFIELD ROAD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182119",
            "telephone_number": "318-861-8938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9403 MANSFIELD ROAD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711182119",
            "telephone_number": "318-861-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN BAYOU COUNSELING AGENCY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "BRITTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-861-8938"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "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 26, 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.