Individual provider Active NPI

Mary James-Thomas

  • Clinical Social Worker
  • Shreveport, LA
National Provider Identifier
1861948143
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
14628 Issued in LA
Practice address
2924 Knight St Ste 426
Shreveport, LA 71105-2414
Phone
(318) 754-3560
Fax
(318) 779-0439
NPI assigned
Aug 28, 2016
Last updated
Jun 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 1790829646 LA
Clinical Social Worker 1041C0700X 14628 LA Primary
Case Manager/Care Coordinator 171M00000X 14628 LA

Addresses

Primary practice location

2924 Knight St Ste 426
Shreveport, LA 71105-2414

Mailing address

932 Francais Dr
Shreveport, LA 71118-4050
Phone (318) 426-2182

Other practice location 1

809 Polk St
Mansfield, LA 71052-2452
Phone (318) 426-2182 ext. 42621

Other identifiers 1

IdentifierTypeStateIssuer
1790829646MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230928000451 LA Practitioner - Clinical Social Worker 2365836533 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1790829646LAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Azalea Health Services Clinical CurrentSince Jul 31, 2023 Accepting new patients
David Raines Community Health Center, Inc CurrentSince Aug 1, 2024 Accepting new patients
David Raines Community Health Center, Inc Current Accepting new patients
Azalea Health Services Texas LLC Clinical CurrentSince Aug 1, 2024 Accepting new patients
David Raines Community Health Center, Inc CurrentSince Aug 1, 2024 Accepting new patients
Vcounselors PLLC PastSince May 16, 2022 Accepting new patients
David Raines Community Health Center, Inc PastSince Jun 30, 2024 Accepting new patients
Forever Healthcare Inc. PastSince Feb 14, 2021 Accepting new patients
Autumn Creek Health Solutions Inc Mental Health PastSince Feb 14, 2021 Accepting new patients
David Raines Community Health Center, Inc. PastSince Aug 15, 2021 Accepting new patients

Locations

1514 Doctors Dr
Bossier City, LA 71111
Phone (318) 549-2500

2401 Old Minden Rd
Bossier City, LA 71112
Phone (318) 723-7242

777 Bearkat Dr
Bossier City, LA 71111
Phone (318) 723-7242

1953 Main St
Haynesville, LA 71038
Phone (318) 227-3350

12201 Mansfield Rd
Keithville, LA 71047
Phone (318) 364-2742

128 Homer Rd
Minden, LA 71055
Phone (318) 377-1545

1625 David Raines Rd
Shreveport, LA 71107
Phone (318) 425-2252

3021 W 70th St
Shreveport, LA 71108
Phone (318) 227-3350

3041 Dr Martin Luther King Dr
Shreveport, LA 71107
Phone (318) 227-3350

3222 Greenwood Rd
Shreveport, LA 71109
Phone (318) 364-5170

351 Hearne Ave
Shreveport, LA 71103
Phone (318) 425-8742

401 W 70th St
Shreveport, LA 71106
Phone (318) 227-3350

4331 Henry St
Shreveport, LA 71109
Phone (318) 364-2300

441 Atlantic Ave
Shreveport, LA 71105
Phone (318) 393-7019

5904 W 70th St
Shreveport, LA 71129
Phone (318) 364-1750

7340 Wyngate Blvd
Shreveport, LA 71106
Phone (318) 687-4812

7611 Saint Vincent Ave
Shreveport, LA 71106
Phone (318) 861-1671

9360 Woolworth Rd
Shreveport, LA 71129
Phone (318) 227-3350

Interoperability endpoints

  • Direct secure messaging: mary.jamesthomas.p1@direct.davidraineschc.nextgenshare.com

Organizations & group practices 10

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1861948143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 FRANCAIS DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711184050",
            "telephone_number": "318-426-2182"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST STE 426",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052414",
            "telephone_number": "318-754-3560",
            "fax_number": "318-779-0439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "809 Polk St",
            "address_purpose": "LOCATION",
            "city": "Mansfield",
            "state": "LA",
            "postal_code": "710522452",
            "country_code": "US",
            "telephone_number": "318-426-2182 x42621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES-THOMAS",
        "first_name": "MARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-28",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "1790829646",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "LA",
            "license": "14628",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "14628",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790829646",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.