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INNERLIGHT WELLNESS LLC NPI 1730536202


NPI Information

NPI: 1730536202
Provider Name: INNERLIGHT WELLNESS, LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
820 JORDAN ST
SUITE 204
SHREVEPORT, LA
ZIP 71101
Phone: (318) 267-0757
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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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther 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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.