Department of Health & Hospitals

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

105 Issued in LA

Legal business name

DEPARTMENT OF HEALTH & HOSPITALS

Doing business as

Shreveport Behavioral Health Clinic - Child & Adolescent

Practice address

2924 Knight St
Building III, 2ND Floor, Suite 350
Shreveport, LA 71105-2415

Phone

(318) 862-3053

Fax

(318) 862-3057

NPI assigned

Aug 20, 2009

Last updated

Jul 31, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Allie D. Allen

Title

Dir. of Operations

Phone

(318) 676-5160

Specialties & licenses 1

Addresses

Other names 1

• Shreveport Behavioral Health Clinic - Child & Adolescent Doing business as

Locations

Practitioners 2

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.

• Frances Edna Hagaman, MD

  • Psychiatry Physician
  • Shreveport, LA
  • NPI 1588773675
  NPD (past)
• Michelle Yetman, PH.D.

  • Clinical Psychologist
  • Shreveport, LA
  • NPI 1306962279
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375228800000",
    "number": "1871725192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST",
            "address_2": "BUILDING III, 2ND FLOOR, SUITE 350",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052415",
            "telephone_number": "318-862-3053",
            "fax_number": "318-862-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2924 KNIGHT ST",
            "address_2": "BUILDING III, 2ND FLOOR, SUITE 350",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052415",
            "telephone_number": "318-862-3053",
            "fax_number": "318-862-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEPARTMENT OF HEALTH & HOSPITALS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-20",
        "last_updated": "2013-07-31",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "ALLIE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "DIR. OF OPERATIONS",
        "authorized_official_telephone_number": "318-676-5160",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "LA",
            "license": "105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shreveport Behavioral Health Clinic - Child & Adolescent",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie Dennison
• Ebony Dent
• Dental Health Clinic, Inc.
• Department of Health & Hospital
• Department of Health & Hospitals (Shreveport Behavioral Health Clinic)
• Department of Health and Hospitals (Pines Treatment Center)
• Department of Health and Hospitals
• Dependable Care Services
• Allison Louise Derise, MD
• Dermatology & Skin Cancer Specialists, LLC

• Adolescent and Children Mental Health Clinic/Center in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Adolescent and Children Mental Health Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2013; 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.