KRYSTAL PEA NPI 1790158400

NPI Information

NPI: 1790158400
Provider Name: KRYSTAL PEA
Classification: Counselor - 101YP2500X
Entity Type: Individual

Specialization: Professional

Address:
2219 CLAIBORNE AVE
SHREVEPORT, LA
ZIP 71103
Phone: (318) 779-0434
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Krystal Pea is a professional counselor in Shreveport, LA. Krystal Pea NPI is 1790158400. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

2219 CLAIBORNE AVE
SHREVEPORT, LA
ZIP 71103-301
Phone: (318) 779-0434
Fax: (318) 210-0000

The enumeration date for this NPI number is 11/3/2015 and was last updated on 5/13/2019.

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
1	101YM0800X	Counselor	Mental Health			No
2	171M00000X	Case Manager/Care Coordinator				No
3	101YP2500X	Counselor	Professional	5809	LOUISIANA	Yes

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

NPI Synchronization or Removal

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