INNERLIGHT WELLNESS LLC NPI 1730536202

NPI Information

  • NPI: 1730536202
  • Provider Name: INNERLIGHT WELLNESS, LLC
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Organization
  • Address: 820 JORDAN ST
    SUITE 204
    SHREVEPORT, LA
    ZIP 71101
  • Phone: (318) 267-0757

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NPI Details

INNERLIGHT WELLNESS, LLC is a professional counselor in Shreveport, LA. INNERLIGHT WELLNESS, LLC NPI is 1730536202. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

820 JORDAN ST
SUITE 204
SHREVEPORT, LA
ZIP 71101-518
Phone: (318) 267-0757
Fax: (318) 670-7232

The provider's authorized official is Nancy Booker Tracy .
The authorized official title is Owner and has the following contact phone number (318) 268-0757.

The enumeration date for this NPI number is 5/15/2016 and was last updated on 5/15/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YP2500XCounselorProfessional3699LOUISIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
12185942MEDICAIDLOUISIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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