NPIMap

Organization Active NPI

Magnolia Recovery, LLC

Doing business as Magnolia Recovery Clinic

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1952093718
Registry record updated Apr 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
MAGNOLIA RECOVERY, LLC
Doing business as
Magnolia Recovery Clinic
Practice address
3605 Youree Dr
Shreveport, LA 71105-2121
Phone
(318) 615-9006
NPI assigned
May 22, 2023
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MAGNOLIA RECOVERY , LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 18, 2024

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

Authorized official

Name
Amanda Veuleman
Title
Operations Director
Phone
(318) 615-9006

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Professional Counselor 101YP2500X NU Primary
Psychologist 103T00000X NU

Addresses

Primary practice location

3605 Youree Dr
Shreveport, LA 71105-2121

Mailing address

3605 Youree Dr
Shreveport, LA 71105-2121
Phone (318) 615-9006

Other names 2

  • Magnolia Recovery Clinic Doing business as
  • Magnolia Recovery Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Recovery LLC2 organizations share this tax ID, including this one
Part of
Magnolia Recovery LLC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3605 Youree Dr
Shreveport, LA 71105
Phone (318) 615-9006

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1684713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1952093718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052121",
            "telephone_number": "318-615-9006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 YOUREE DR",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052121",
            "telephone_number": "318-615-9006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA RECOVERY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAGNOLIA RECOVERY , LLC",
        "enumeration_date": "2023-05-22",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "status": "A",
        "authorized_official_last_name": "VEULEMAN",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "318-615-9006"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Recovery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Recovery",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Apr 18, 2024; 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.