Active NPI
Brandon Slacks
- Mental Health Counselor
- Mansfield, LA
National Provider Identifier
1972055804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 00902654
- Practice address
- 117 Carolyn St
Mansfield, LA 71052-2901 - Phone
- (318) 461-1215
- NPI assigned
- Oct 26, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 00902654 | LA | Primary |
Addresses
Primary practice location
117 Carolyn St
Mansfield, LA 71052-2901
Mailing address
117 Carolyn St
Mansfield, LA 71052-2901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00902654 | LA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477440000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477440000000",
"number": "1972055804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 CAROLYN ST",
"city": "MANSFIELD",
"state": "LA",
"postal_code": "710522901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "117 CAROLYN ST",
"city": "MANSFIELD",
"state": "LA",
"postal_code": "710522901",
"telephone_number": "318-461-1215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLACKS",
"first_name": "BRANDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-10-26",
"last_updated": "2016-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "00902654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mansfield, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.