LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER (NPI# 1689901316) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689901316 |
| Entity Type | Organization |
| Organization Name | LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER |
| Other Organization Name | ALLIED HEALTH CLINICS |
| Practice Address |
1450 Claiborne Ave Shreveport LA 71103-4204 |
| Mailing Address |
1501 Kings Hwy Shreveport LA 71103-4228 |
| Practice Telephone | 3188132962 |
| Practice Fax Number | 3188132981 |
| Enumeration Date | 2009-11-18 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | REVA MATTHIEW ROBINSON (DIRECTOR OF CLIN MGMT SYSTEM) |
| Authorized Official Telephone | 3188132962 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YP2500X |
Counselor Specialization: Professional |
Behavioral Health & Social Service Providers | ||
| N | 103TC0700X |
Psychologist Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care | ||
| Y | 103T00000X | Psychologist | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1884324 | 05 | |
| LA | 1174173 | 05 |
| Other Name | Type Code |
|---|---|
| Allied Health Clinics | Doing Business As Name - Organization |
| Children's Center | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871765982 | Louisiana State University Health Sciences Center | Family Medicine | 2351 Vandenburg Drive, Alexandria, LA 71311 | 2008-03-28 |
| 1154461937 | Louisiana State University Health Sciences Center | Audiologist | 3735 Blair Dr, Shreveport, LA 71103-4601 | 2007-02-08 |
| 1346609526 | Louisiana State University Health Sciences Center | Durable Medical Equipment & Medical Supplies | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2016-02-17 |
| 1801239926 | Louisiana State University Health Sciences Center | General Acute Care Hospital | 5825 Airline Hwy, Baton Rouge, LA 70805-2408 | 2013-04-08 |
| 1144544529 | Louisiana State University Health Sciences Center | Counselor | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2010-03-15 |
| 1437383106 | Louisiana State University Health Sciences Center | Clinical Medical Laboratory | 1501 Kings Hwy, Dpeartment of Surgery Histocompatibility Laboratory, Shreveport, LA 71103-4228 | 2009-05-11 |
| 1649438532 | Louisiana State University Health Sciences Center | Internal Medicine | 1501 Kings Hwy, Department of Internal Medicine - Section of Nephrology, Shreveport, LA 71103-4228 | 2008-05-28 |
| 1316119167 | Louisiana State University Health Sciences Center | Internal Medicine | 4864 Jackson St, Monroe, LA 71202-6400 | 2008-04-01 |
| 1962674713 | Louisiana State University Health Sciences Center | Emergency Medicine | 4864 Jackson St, Monroe, LA 71202-6400 | 2008-04-01 |
| 1952573701 | Louisiana State University Health Sciences Center | General Acute Care Hospital | 1501 Kings Hwy, Shreveport, LA 71103-4228 | 2008-04-01 |
| Street Address |
1450 CLAIBORNE AVE |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71103-4204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720023773 | Amanda Mahoney | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2006-06-16 |
| 1538773866 | Carson Kolbenschlag | Physical Therapy Assistant | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-09-03 |
| 1679182083 | Summer Abdallah | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-07-31 |
| 1720697816 | Jared Daigle | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-07-24 |
| 1417566597 | Layne Lockwood | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-07-24 |
| 1528676038 | Sarah Murnane | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-07-21 |
| 1437772829 | Katelyn Elizabeth Taylor | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2020-05-20 |
| 1548817273 | Nicholas Andrew Russell | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2019-08-19 |
| 1619521358 | Zachary Pitre | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2019-07-31 |
| 1528612850 | Carly Paige Funderburk | Physical Therapist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2019-07-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083124887 | Elizabeth Ponder | Case Manager/Care Coordinator | 404 Hearne Avenue, Shreveport, LA 71103 | 2017-10-05 |
| 1245648393 | Madiha Tariq | General Acute Care Hospital | Rheumatology Clinic, 1501 Kings Hwy, Sheveport, LA 71103 | 2014-07-31 |
| 1659782688 | Jennifer G Smith | Pharmacist | 1725 Claiborne Ave, Shreveport, LA 71103 | 2014-05-13 |
| 1336568823 | Taylor Jieun Jung | Student in an Organized Health Care Education/Training Program | Lsu Health Sciences Center 1501 Kings Highway, Department of Oral & Maxillofacial Surgery Room 530, Shreveport, LA 71103 | 2014-04-10 |
| 1578984746 | Jamie Terrell | Pharmacist | 1625 Claiborne Ave, Shreveport, LA 71103 | 2013-12-13 |
| 1346675188 | Srijan Tandukar | Internal Medicine | 2751 Albert L Bicknell Dr Ste 2b, Shreveport, LA 71103 | 2013-09-12 |
| 1699017681 | Deanna Elise Mossallati | Internal Medicine | 8551 Greenwood Rd, Suite 410, Shreveport, LA 71103 | 2013-03-18 |
| 1346527330 | Tim M Smith | Clinical Exercise Physiologist | 3200 Greenwood Rd., Shreveport, LA 71103 | 2011-11-04 |
| 1144451683 | Second Chance Recovery | Durable Medical Equipment & Medical Supplies | 3816 Linwood, Shreveport, LA 71103 | 2009-07-31 |
| 1093919920 | Neeraj Singh | Internal Medicine | 2751 Albert L Bicknell Dr Fl 4, Shreveport, LA 71103 | 2007-06-13 |
| Find all providers in zip 71103 | ||||
| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750761847 | Michael Todd Lobrano | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2015-06-03 |
| 1114347846 | Jennifer Russell | Psychologist | 3341 Youree Dr Ste 20a, Shreveport, LA 71105-2149 | 2014-04-21 |
| 1730487844 | M Patrick Davenport Appc | Psychologist | 1002 Highland Ave, 3rd Floor, Shreveport, LA 71101-4143 | 2011-03-14 |
| 1497900187 | Adam Thomas Blancher | Psychologist | 1450 Claiborne Ave, Shreveport, LA 71103-4204 | 2008-11-21 |
| 1326254905 | Robert L. Krenek Jr. | Psychologist | 510 E Stoner Ave, Shreveport, LA 71101-4243 | 2007-05-14 |
| 1376678045 | Gary E. Milford | Psychologist | 2520 Line Ave, Shreveport, LA 71104-3022 | 2007-02-22 |
| 1760549372 | Willow Point Baptist Healing Heart Counseling Center | Psychologist | 820 Jordan St, Suite 401, Shreveport, LA 71101 | 2007-01-02 |
| 1447337787 | Council for Advancement of Social Service and Education | Psychologist | 2120 Bert Kouns Industrial Loop, Ste. E, Shreveport, LA 71118-3351 | 2006-11-01 |
| 1497842702 | Lisa Harper | Psychologist | 5803 Youree Dr, Ste 200, Shreveport, LA 71105-4243 | 2006-10-06 |
| 1487765665 | G Perry Hill | Psychologist | 7330 Fern Ave, Suite 602, Shreveport, LA 71105 | 2006-08-31 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71103 |
Please comment or provide details below to improve the information on LOUISIANA STATE UNIVERSITY HEALTH SCIENCES CENTER.
| 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.