Freddie Mingo

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

8370 Old Mooringsport Rd
Shreveport, LA 71107-9273

Phone

(318) 422-5567

NPI assigned

Sep 26, 2018

Reactivated

May 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1537920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1982189957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8370 OLD MOORINGSPORT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079273",
            "telephone_number": "318-422-5567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8370 OLD MOORINGSPORT RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711079273",
            "telephone_number": "318-422-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINGO",
        "first_name": "FREDDIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-26",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "deactivation_date": "2020-04-17",
        "reactivation_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mind Rehabilitation and Resource Center, Inc
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• Mindset Matters Behavioral Health LLC.
• Alicia Mingo, LPN, CCHC, CBS, CBE,
• Crystal Mingo
• Minimally Invasive Surgery Center of Louisiana
• Lerhonda Minniefield
• Anil Minocha, MD
• Anedra Minor, BSW, M.ED, NCED
• Kirstin Minor

• Mental Health Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2021; 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.