1659755833 NPI number — GILCHRIST COUNSELING & CONSULTING, LLC

Table of content: SHEA ELIZABETH SMITH LMSW (NPI 1043983638)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659755833 NPI number — GILCHRIST COUNSELING & CONSULTING, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GILCHRIST COUNSELING & CONSULTING, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1659755833
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 52772
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHREVEPORT
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71135-2772
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-302-0457
Provider Business Mailing Address Fax Number:
318-747-6971

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4859 SHED RD
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
BOSSIER CITY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71111-5492
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-302-0457
Provider Business Practice Location Address Fax Number:
318-747-6971
Provider Enumeration Date:
07/16/2015

Additional Information

Authorized Official

Authorized Official Last Name:
GILCHRIST
Authorized Official First Name:
APRL
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
318-302-0457

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  4556 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com