Fowler, Shannon K
Fowler, Shannon K is an individual health care provider with primary practice located at 6811 Fairfield Ave , Shreveport LA 71106-3803. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Other Service Providers / Case Manager/Care Coordinator. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Fowler, Shannon K can be contacted via phone (318) 216-5088.Contact Information
Primary practice address
6811 Fairfield Ave
Shreveport LA 71106-3803
Phone: (318) 216-5088
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 7745 | Louisiana |
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | LPC7745 | Louisiana |
Profile Details
| NPI number | 1194099259 |
|---|---|
| LBN Legal business name | Fowler, Shannon K |
| Credentials | LPC LICENSE NO 7745 |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 6th, 2012 |
| Last updated | Apr 27th, 2023 - about 3 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 | 1194099259 | NPPES |
| Louisiana | MEDICAID | 1194099259 | |
| Louisiana | MEDICAID | 3156148 |
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