NPIMap

Organization Active NPI

Positive Change Counseling Agency

  • Community/Behavioral Health Agency
  • Shreveport, LA
National Provider Identifier
1891130084
Registry record updated Jan 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
POSITIVE CHANGE COUNSELING AGENCY
Practice address
351 W 79TH St
Shreveport, LA 71106-4819
Phone
(318) 688-8190
Fax
(318) 688-8193
NPI assigned
May 1, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2017

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

Authorized official

Name
Mr. Marty Tyrone Johnson Sr.
Title
Owner
Phone
(318) 779-8527

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

351 W 79TH St
Shreveport, LA 71106-4819

Mailing address

348 W 79TH St
Shreveport, LA 71106-4820
Phone (318) 688-8190

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1483574400000",
    "number": "1891130084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W 79TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711064820",
            "telephone_number": "318-688-8190",
            "fax_number": "318-688-8193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 W 79TH ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711064819",
            "telephone_number": "318-688-8190",
            "fax_number": "318-688-8193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POSITIVE CHANGE COUNSELING AGENCY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-01",
        "last_updated": "2017-01-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARTY",
        "authorized_official_middle_name": "TYRONE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-779-8527",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "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 Jan 5, 2017; 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.