MR. LARRY COLENZO WILSON (NPI# 1750869285) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750869285 |
| Entity Type | Individual |
| Full Name | MR. LARRY COLENZO WILSON |
| Practice Address |
6224 N Inwood Rd Shreveport LA 71119-7213 |
| Practice Telephone | 3184530447 |
| Mailing Telephone | 3184530447 |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2018-08-06 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992171086 | Larry Wilson | Chiropractor | 800 W Platt St Ste 2, Tampa, FL 33606-4112 | 2015-08-12 |
| 1528211232 | Larry James Wilson | Social Worker | 1572 Zephyr Ave, El Cajon, CA 92021-3560 | 2008-10-25 |
| 1538344908 | Larry Dwight Wilson Jr. | Counselor | 3020 18th St Suite 17, Catholic Charities, Columbus, NE 68601-4254 | 2008-01-04 |
| 1689749582 | Larry Flick Wilson | Preventive Medicine | Faa, Ace-300, 901 Locust Street, Rm 350, Kansas City, MO 64106 | 2006-11-24 |
| 1932297892 | Larry Don Wilson | Dentist | 2247 Helton Dr, Florence, AL 35630-1063 | 2006-10-10 |
| 1275541344 | Larry Bertram Wilson | Dentist | 721 W Arapaho Rd, #102, Richardson, TX 75080-4155 | 2006-08-04 |
| 1801819495 | Larry Al Wilson | Counselor | 2708 E Tanager Trl, Orange, TX 77632-0750 | 2006-07-25 |
| 1134121221 | Larry T Wilson | Family Medicine | 701 S Morgan Ave, Andrews, SC 29510 | 2005-06-02 |
| 1063918167 | Larry Wilson | Case Manager/Care Coordinator | 418 Center St, Wheelersburg, OH 45694-1712 | 2018-04-05 |
| 1801390273 | Larry Greg Wilson | Case Manager/Care Coordinator | 115 Private Road 977, Pedro, OH 45659-8608 | 2018-03-21 |
| Street Address |
6224 N INWOOD RD |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71119-7213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912549825 | Andrea Lekesha Brown | Case Manager/Care Coordinator | 3518 Milky Way, Shreveport, LA 71119 | 2019-10-11 |
| 1003380213 | Eiyana Middleton | Case Manager/Care Coordinator | 5720 S Lakeshore Dr Apt 1711, Shreveport, LA 71119 | 2019-01-22 |
| 1508341264 | Cassandra Marshall | Case Manager/Care Coordinator | 5905 Candlewood, Shreveport, LA 71119 | 2018-09-28 |
| 1184125734 | Shunda Huff | Case Manager/Care Coordinator | 5636 S Lakeshore Dr Apt 632, Shreveport, LA 71119 | 2018-02-27 |
| 1093239162 | Nicole Devona Wahsington | Counselor | 2811 Metal Street, Shreveport, LA 71119 | 2017-07-31 |
| 1396266318 | Cynthia M Thomas | Driver | 6407 Santa Monica Blvd., Shreveport, LA 71119 | 2017-06-29 |
| 1154861771 | Allan Thomas | Case Manager/Care Coordinator | 3205 Linda St, Shreveport, LA 71119 | 2017-03-01 |
| 1366984312 | Demetria Carter | Counselor | 4164 Mcmichael Ave, Shreveport, LA 71119 | 2016-11-08 |
| 1033667712 | Mary Craig | Case Manager/Care Coordinator | 6215 Border Ln, Shreveport, LA 71119 | 2016-09-12 |
| 1538615067 | Jesse Fallis | Counselor | New Day Recovery/ Shreveport, 6240 Greenwood Rd, Shreveport, LA 71119 | 2016-08-25 |
| Find all providers in zip 71119 | ||||
| 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 | 71119 |
Please comment or provide details below to improve the information on MR. LARRY COLENZO WILSON.
| 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.