MISS MALOREE BREANNE WILKINS (NPI# 1720639149) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720639149 |
| Entity Type | Individual |
| Full Name | MISS MALOREE BREANNE WILKINS |
| Practice Address |
2924 Knight St Shreveport LA 71105-2415 |
| Mailing Address |
2106 Silverwood Dr Shreveport LA 71118-5023 |
| Practice Telephone | 3816311122 |
| Mailing Telephone | 8173208808 |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2019-09-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | LA | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1939846 | 05 |
| Street Address |
2924 KNIGHT ST |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-2415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588773675 | Frances Edna Hagaman | Psychiatry & Neurology | 2924 Knight St, Building 3 Suite 350, Shreveport, LA 71105-2415 | 2006-08-30 |
| 1104456581 | Shavonda Rachel Jones | Counselor | 2924 Knight St, Shreveport, LA 71105-2415 | 2020-01-24 |
| 1285158907 | Julie Anna Wyatt | Counselor | 2924 Knight St, Shreveport, LA 71105-2415 | 2017-08-03 |
| 1043751670 | Unconditional Care Behavioral Center | Community/Behavioral Health | 2924 Knight St, Suite 318, Shreveport, LA 71105-2415 | 2017-03-15 |
| 1326584327 | Faye S Player | Social Worker | 2924 Knight St, Suite 426, Shreveport, LA 71105-2415 | 2017-01-13 |
| 1700329950 | Aynslee Camille Wilmot | Behavior Technician | 2924 Knight St, Suite 434, Shreveport, LA 71105-2415 | 2016-11-21 |
| 1235681586 | Valerie Dawn Millikin | Counselor | 2924 Knight St, 426, Shreveport, LA 71105-2415 | 2016-11-02 |
| 1629529250 | Chassity Brown | Counselor | 2924 Knight St, Suite 318, Shreveport, LA 71105-2415 | 2016-10-19 |
| 1225488489 | Kerenie Spencer | Counselor | 2924 Knight St, Shreveport, LA 71105-2415 | 2016-06-20 |
| 1518316884 | Delani Hinton | Counselor | 2924 Knight St, Suite 426, Shreveport, LA 71105-2415 | 2016-06-08 |
| Find all providers in the same location | ||||
| 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 | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360887 | Halena Jones | Case Manager/Care Coordinator | 9409 Chaparral Ln, Shreveport, LA 71118-4337 | 2020-09-11 |
| 1598376196 | Michaela Nicole Bradley | Case Manager/Care Coordinator | 10021 Stratmore Cir, Shreveport, LA 71115-3416 | 2020-08-17 |
| 1619585791 | Kimberly Bissell | Case Manager/Care Coordinator | 7505 Pines Rd Ste 1115, Shreveport, LA 71129-3900 | 2020-07-15 |
| 1902414170 | Unique Lashae Lister | Case Manager/Care Coordinator | 2611 Corbitt St, Shreveport, LA 71108-2805 | 2020-07-14 |
| 1407474828 | Angela Harris | Case Manager/Care Coordinator | 1111 W 70th St Apt 93, Shreveport, LA 71106-3558 | 2020-07-13 |
| 1669096921 | Ryan Barham | Case Manager/Care Coordinator | 824 Oneonta St, Shreveport, LA 71106-1130 | 2020-06-02 |
| 1922621085 | Julian White | Case Manager/Care Coordinator | 8529 Grover Pl, Shreveport, LA 71115-2707 | 2020-05-24 |
| 1396368817 | Shannon Marie Cannon | Case Manager/Care Coordinator | 1543 Summers St, Shreveport, LA 71108-3131 | 2020-05-19 |
| 1730701954 | Brianna Mason | Case Manager/Care Coordinator | 1533 Marshall St, Shreveport, LA 71101-3941 | 2020-05-11 |
| 1295355238 | Angela Rice | Case Manager/Care Coordinator | 2704 Frostwood Dr, Shreveport, LA 71108-5524 | 2020-04-20 |
| Find all providers in SHREVEPORT | ||||
| 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.