DEANGELO BROOKS (NPI# 1114495603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114495603 |
| Entity Type | Individual |
| Full Name | DEANGELO BROOKS |
| Practice Address |
1105 Island Park Blvd Apt 1126 Shreveport LA 71105-4783 |
| Mailing Address |
5720 S Lakeshore Dr Apt 605 Shreveport LA 71119-3930 |
| Practice Telephone | 3184047134 |
| Mailing Telephone | 3184047134 |
| Enumeration Date | 2018-11-02 |
| Last Update Date | 2020-09-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers | ||
| Y | 171000000X | Military Health Care Provider | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346795846 | Deangelo Deshaun Brooks | Counselor | 5200 Park Rd Ste 218b, Charlotte, NC 28209-3650 | 2016-08-24 |
| Street Address |
1105 ISLAND PARK BLVD APT 1126 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-4783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336340777 | Red River Army Depot | Military Health Care Provider | 9403 Evergreen Dr, Shreveport, LA 71118-3935 | 2007-05-31 |
| 1194871731 | Jessica Jamison | Military Health Care Provider | 7505 Pines Rd Ste 1255, Shreveport, LA 71129-3923 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700186434 | Devin Anthony Keeton | Military Health Care Provider | 759 Pinetree St, Slidell, LA 70458-4413 | 2010-10-28 |
| 1003079195 | Christopher Lynn Anderson | Military Health Care Provider | 1790 Saturn Blvd, New Orleans, LA 70129 | 2008-07-08 |
| 1013534783 | James T Bridges | Military Health Care Provider | 2439 Manhattan Blvd, Harvey, LA 70058-5328 | 2020-06-29 |
| 1366938151 | Saudia Fatima Dolliole | Military Health Care Provider | 4300 S I 10 Service Rd W Ste 215, Metairie, LA 70001-7436 | 2018-07-05 |
| 1033516042 | Gina Markle | Military Health Care Provider | 1790 Saturn Blvd, New Orleans, LA 70129 | 2014-11-20 |
| 1619202520 | Suzanne Noland Hammel | Military Health Care Provider | 122 Sierra Ct, Metairie, LA 70001-5326 | 2009-10-09 |
| 1366611055 | United States Coast Guard | Military Health Care Provider | 13800 Old Gentilly Rd, New Orleans, LA 70129-2218 | 2008-02-27 |
| 1043401607 | Jesse Andrew Walton | Military Health Care Provider | 13800 Old Gentilly Rd, Medical Division, New Orleans, LA 70129-2218 | 2007-08-07 |
| 1326012949 | Daniel James Feeney | Military Health Care Provider | 243 Curtiss Rd Ste 100, Barksdale Afb, Barksdale Afb, LA 71110-2425 | 2006-02-13 |
| City | SHREVEPORT |
| Zip Code | 71105 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.