Street, Jeanne
Street, Jeanne is an individual health care provider with primary practice located at 610 Herndon Ave , Shreveport LA 71101. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Street, Jeanne can be contacted via phone (318) 424-3867.Contact Information
Primary practice address
610 Herndon Ave
Shreveport LA 71101
Phone: (318) 424-3867
Fax: (318) 424-5006
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 342 | Louisiana |
Profile Details
| NPI number | 1033273107 |
|---|---|
| LBN Legal business name | Street, Jeanne |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 21st, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033273107 | NPPES |
| Louisiana | Other | 20777 | BCBS |
| Louisiana | MEDICAID | 1105961 | BCBS |
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