DR. NASREEN AZHAR MALLIK (NPI# 1215034475) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215034475 |
| Entity Type | Individual |
| Full Name | DR. NASREEN AZHAR MALLIK |
| Credential | MD |
| Practice Address |
2495 Shreveport Hwy # 71 Pineville LA 71360-4044 |
| Mailing Address |
Po Box 69004 Alexandria LA 71306-9004 |
| Practice Telephone | 3184730010 |
| Practice Fax Number | 3184835036 |
| Mailing Telephone | 3184662593 |
| Mailing Fax Number | 3184835091 |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2019-05-30 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
34676 | TN | Allopathic & Osteopathic Physicians |
| Street Address |
2495 SHREVEPORT HWY # 71 |
| City | PINEVILLE |
| State | LA |
| Zip Code | 71360-4044 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982692364 | Ihor Andrew Zakaluzny | Surgery | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2005-10-11 |
| 1063975449 | Jill Baker | Social Worker | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2019-04-11 |
| 1235629528 | Tedra Watkins Scott | Social Worker | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2018-05-13 |
| 1659888204 | Dean Jan | Pharmacist | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2018-01-04 |
| 1104279025 | Gwendolyn Parker | Registered Nurse | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2016-07-15 |
| 1205206968 | Delisha Smith | Occupational Therapist | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2015-10-06 |
| 1679959092 | Sharin Guinn Deloach | Social Worker | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2015-08-07 |
| 1689057770 | Jason Stewart | Physical Therapy Assistant | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2015-07-07 |
| 1851774376 | Jason Desselle | Specialist | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2015-07-01 |
| 1598145674 | Shaun Steffen Siebeneicher | Physical Therapist | 2495 Shreveport Hwy # 71, Pineville, LA 71360-4044 | 2015-06-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578110789 | Reneisha Armonii Roberts | Pharmacist | 3100 La-28, Pineville, LA 71360 | 2019-08-22 |
| 1396303145 | Tina Marie Lawhorn | Nurse Practitioner | 2945 Shreveport Hwy, Pineville, LA 71360 | 2019-06-05 |
| 1942773213 | Tioga Pharmacy LLC | Pharmacy | 5101 Shreveport Hwy, Pineville, LA 71360 | 2019-01-09 |
| 1649755497 | Jessica Wooten | Nurse Practitioner | 292 Jerry Lofton Rd, Pineville, LA 71360 | 2018-09-27 |
| 1215421995 | Elizabeth Simon-clark | Counselor | Central La State Hospital Unit 6 Meadows Lane, Pineville, LA 71360 | 2018-06-18 |
| 1982116497 | Dm Properties of Rapides, LLC | Radiology | 2705 Highway 28 E Ste B, Pineville, LA 71360 | 2017-10-25 |
| 1508384587 | Marion Patrick Hazelton I | Counselor | Pathways Red River Treatment Center, 242 West Shamrock Ave Unit 6 Melody Lane, Pineville, LA 71360 | 2017-08-30 |
| 1669902557 | Jessica Williams | Social Worker | Unit 6 Wing A Meadow Lane, Pineville, LA 71360 | 2017-06-14 |
| 1104365840 | Naomi Gates | Social Worker | 242 W Shamrock Unit 1, Pineville, LA 71360 | 2017-02-14 |
| 1861930224 | Sharon Humphrey | Counselor | 5400 Service Rd B206, Pineville, LA 71360 | 2017-02-06 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205913993 | Reuben Sanford Roy Jr. | Psychiatry & Neurology | 242 W. Shamrock St., Pineville, LA 71360-6439 | 2006-11-01 |
| 1710063763 | Vijaya L. Boppana | Psychiatry & Neurology | 242 West Shamrock Street, Pineville, LA 71360 | 2006-10-31 |
| 1518054881 | John Martin Smith | Psychiatry & Neurology | 242 W Shamrock Street, Pineville, LA 71360 | 2006-10-06 |
| 1710078613 | Claire Jean Purdome Luelf | Psychiatry & Neurology | 2495 Shreveport; Highway 71 North, Va Medical Center - Alexandria, Pineville, LA 71360 | 2006-09-27 |
| 1114283835 | Jaymee Smith Nelson | Psychiatry & Neurology | 2495 Shreveport Hwy # 71n, Pineville, LA 71360 | 2012-04-06 |
| 1639490154 | Gary Bryan Fillette | Psychiatry & Neurology | 242 W Shamrock Ave Unit 1, Pineville, LA 71360-6439 | 2010-06-18 |
| 1861691503 | Victor Johnson Vautrot | Psychiatry & Neurology | 2495 Shreveport Hwy, Pineville, LA 71360-4044 | 2007-07-12 |
| 1104021575 | Sonia Rodriguez | Psychiatry & Neurology | 2495 Shreveport Hwy 71n, V A Medical Center, Pineville, LA 71360 | 2007-06-18 |
| 1275624934 | Paul Aldo Molinar | Psychiatry & Neurology | 2495 Shreveport Hwy, Hwy 71 North, Pineville, LA 71360-4044 | 2006-09-27 |
| 1972612570 | Edgard Laborde Jr. | Psychiatry & Neurology | Va Medical Center, 2495 Shreveport Highway, Pineville, LA 71360 | 2006-08-29 |
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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.