MCMILLIAN THERAPY SERVICES, INC (NPI# 1568682219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568682219 |
| Entity Type | Organization |
| Organization Name | MCMILLIAN THERAPY SERVICES, INC |
| Practice Address |
1800 Buckner St Suite C-200 Shreveport LA 71101-4440 |
| Practice Telephone | 3182279002 |
| Practice Fax Number | 3182279025 |
| Mailing Telephone | 3182279002 |
| Mailing Fax Number | 3182279025 |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. SUZANNE VINES MCMILLIAN (CEO) |
| Authorized Official Telephone | 3182279002 |
| Authorized Official Credential | LOTR |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 101Y00000X | Counselor | 1744 | LA | Behavioral Health & Social Service Providers |
| X | 101YM0800X |
Counselor Specialization: Mental Health |
1744 | LA | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 534 | LA | Behavioral Health & Social Service Providers |
| X | 106H00000X | Marriage & Family Therapist | 3919 | TX | Behavioral Health & Social Service Providers |
| X | 225XP0200X |
Occupational Therapist Specialization: Pediatrics |
Z10975 | LA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
1800 BUCKNER ST SUITE C-200 |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71101-4440 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710972559 | Arnold E Barz | Internal Medicine | 1800 Buckner St, Suite C120, Shreveport, LA 71101-4440 | 2005-09-19 |
| 1538488028 | Mary Mladenka-dowden | Nurse Practitioner | 1800 Buckner St, Suite C-120, Shreveport, LA 71101-4440 | 2010-05-23 |
| 1164654646 | Audrey Rachal Smith | Nurse Practitioner | 1800 Buckner St, Suite C-120, Shreveport, LA 71101-4440 | 2009-08-17 |
| 1972741197 | Brittany M Jellum | Physical Therapy Assistant | 1800 Buckner St, Suite C 200, Shreveport, LA 71101-4440 | 2009-01-26 |
| 1154508364 | Delta Medical Services | PACE Provider Organization | 1800 Buckner St, Suite B210, Shreveport, LA 71101-4440 | 2008-01-30 |
| 1740465798 | Zulqarnain Abro | Internal Medicine | 1800 Buckner St, Suite C120, Shreveport, LA 71101-4440 | 2008-01-08 |
| 1356524078 | Shawna Woods Chumley | Occupational Therapist | 1800 Buckner St, C-200, Shreveport, LA 71101-4440 | 2007-12-17 |
| 1316120512 | Kathy Kelley Hughes | Speech-Language Pathologist | 1800 Buckner St, Suite C-200, Shreveport, LA 71101-4440 | 2007-12-11 |
| 1952582991 | The Center for Therapy Pediatric Therapy Services | Occupational Therapist | 1800 Buckner St, C-200, Shreveport, LA 71101-4440 | 2007-11-19 |
| 1932380961 | Molly C Wierick | Occupational Therapist | 1800 Buckner St, C-200, Shreveport, LA 71101-4440 | 2007-11-19 |
| 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 | 101Y00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification. |
| Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020479 | Whites All Star Consultant | Counselor | 631 E 85th St, Shreveport, LA 71106-5819 | 2020-07-10 |
| 1063046381 | Sharon H Harris | Counselor | 4420 Fairway Dr, Shreveport, LA 71109-4002 | 2020-02-25 |
| 1316422785 | Valencia Sims | Counselor | 6143 Buncombe Rd, Shreveport, LA 71129-4109 | 2018-10-01 |
| 1467954909 | Staughton Jennings | Counselor | 8501 Millicent Way Apt 1085, Shreveport, LA 71115-2231 | 2018-02-28 |
| 1790283638 | Brookys Haven | Counselor | 217 Jones St, Shreveport, LA 71101-4021 | 2018-01-25 |
| 1356859680 | Keshunna Goode | Counselor | 6308 Border Ln, Shreveport, LA 71119-7204 | 2018-01-22 |
| 1407364409 | Kelly Jane Casey | Counselor | 2620 Centenary Blvd Ste 207, Shreveport, LA 71104-3350 | 2018-01-12 |
| 1932619442 | Mark Bolding | Counselor | 8021 Fairfield Ave, Shreveport, LA 71106-5627 | 2017-10-10 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619493830 | Amri A Warren | Counselor | 2403 Helmsdale Ct, Shreveport, LA 71118-4546 | 2017-08-18 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71101 |
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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.