MISS ULISSA SAMONE EDWARDS (NPI# 1396269171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396269171 |
| Entity Type | Individual |
| Full Name | MISS ULISSA SAMONE EDWARDS |
| Practice Address |
820 Jordan St Shreveport LA 71101-4518 |
| Practice Telephone | (318) 208-8400 |
| Mailing Telephone | 3182088400 |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-08-02 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 814371750 | 05 |
| Street Address |
820 JORDAN ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139098 | Red River Orthotic Specialists, LLC | Prosthetic/Orthotic Supplier | 820 Jordan St, Suite 110, Shreveport, LA 71101-4518 | 2005-07-22 |
| 1154845196 | Kelvin Wayne Latson | Counselor | 820 Jordan St, Shreveport, LA 71101-4518 | 2017-08-01 |
| 1033633201 | Monica Burns | Counselor | 820 Jordan St, Ste. 507, Shreveport, LA 71104 | 2017-07-31 |
| 1811410376 | Aaliyah Janee' Watkins | Counselor | 820 Jordan St, Shreveport, LA 71101-4518 | 2017-07-17 |
| 1275983363 | Morris Crichlow | Counselor | 820 Jordan St, Suite 204, Shreveport, LA 71101-4518 | 2016-06-20 |
| 1730536202 | Innerlight Wellness, LLC | Counselor | 820 Jordan St, Suite 204, Shreveport, LA 71101-4518 | 2016-05-15 |
| 1548661440 | Tiffany Alyce Roe | Nurse Practitioner | 820 Jordan St, Suite 201, Shreveport, LA 71101-4518 | 2014-09-10 |
| 1861812307 | Carol Hamilton Brill | Counselor | 820 Jordan St, Suite 510-c, Shreveport, LA 71101-4518 | 2014-04-23 |
| 1659701209 | Latoya Houston | Nurse Practitioner | 820 Jordan St, Suite 501, Shreveport, LA 71101-4518 | 2013-11-19 |
| 1669818985 | Kelly M Tyner | Marriage & Family Therapist | 820 Jordan St, Suite 570, Shreveport, LA 71101-4518 | 2013-05-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255988630 | Renee Jewitt | Case Manager/Care Coordinator | 1513 Line Avenue, Suite 225, Shreveport, LA 71101 | 2019-08-21 |
| 1942770094 | Bessie Larry | Case Manager/Care Coordinator | 1513 Line Av, 222, Shreveport, LA 71101 | 2018-12-03 |
| 1750875944 | Jarvis Decarleonne Larry | Community Health Worker | 1513 Line Ave # 222, Shreveport, LA 71101 | 2018-06-20 |
| 1871083485 | Kimberly B. Mcclelland, Lcsw | Counselor | 820 Jordan St. Ste 510w, Shreveport, LA 71101 | 2018-05-18 |
| 1982106456 | Hudson Amc LLC | Internal Medicine | 1800 Irving Place, Shreveport, LA 71101 | 2018-03-01 |
| 1528572955 | Spencer Ron Floyd | Counselor | 1717 Marshall Street, Shreveport, LA 71101 | 2017-11-21 |
| 1578088076 | Brittany Morris | Case Manager/Care Coordinator | 1835 Spring Street Annex Building, Shreveport, LA 71101 | 2017-08-07 |
| 1275058794 | Diane Williams | Case Manager/Care Coordinator | 217 Jones St Apt 510, Shreveport, LA 71101 | 2017-08-04 |
| 1386195972 | Jakeya Woodbury | Counselor | 453 Stoner Ave, Shreveport, LA 71101 | 2016-10-18 |
| 1922459643 | Arlene Huling | Counselor | 449 Egan Street, Shreveport, LA 71101 | 2016-06-23 |
| Find all providers in zip 71101 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639786502 | Erik Rasmussen | Counselor | 670 Albemarle Dr Ste 700, Shreveport, LA 71106-5946 | 2020-09-25 |
| 1043842750 | Creative Community Counseling LLC | Counselor | 2920 Knight St Ste 131, Shreveport, LA 71105-2412 | 2020-02-11 |
| 1477191591 | Keona Chequise Kidd | Counselor | 2829 Dunlap St, Shreveport, LA 71103-2244 | 2019-12-19 |
| 1336781632 | A New Beginning Counseling Services, LLC | Counselor | 9441 Oleander Dr, Shreveport, LA 71118-4008 | 2019-10-08 |
| 1841840311 | Theresa Davidson Snow | Counselor | 820 Jordan St Ste 510w, Shreveport, LA 71101-4526 | 2019-09-17 |
| 1962057737 | Mariana Penny | Counselor | 152 E College St, Shreveport, LA 71104-2510 | 2019-08-07 |
| 1528622818 | Kendal Redel | Counselor | 10011 Hanover Dr, Shreveport, LA 71115-3430 | 2019-04-23 |
| 1962960351 | Brandon Lewis-graham | Counselor | 3201 Knight St Apt 2206, Shreveport, LA 71105-2749 | 2019-03-05 |
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1659840312 | Donna Brown Franks | Counselor | 236 E Gregg St, Shreveport, LA 71104-5119 | 2018-11-24 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
Please comment or provide details below to improve the information on MISS ULISSA SAMONE EDWARDS.
| 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.