Mbrace Wellness, LLC
Counselor, Mental Health in Shreveport, LA. Organization (NPI-2).
NPI number1124862693
StatusActive
Last updated in NPPESJun 20, 2024
Details
- NPI
- 1124862693
- Entity type
- Organization (NPI-2)
- Legal business name
- Mbrace Wellness, LLC
- Organization subpart
- No
- Enumeration date
- Jun 20, 2024
- Certification date
- Jun 20, 2024
- Last updated
- Jun 20, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YM0800X | Counselor, Mental Health | – | – | Yes |
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | – | – |
Practice location
2924 Knight Street, Suite 412Shreveport, LA 71105-2413
Phone 318-200-0713
Mailing address
5735 Dixie Shreveport RdShreveport, LA 71107-8991
Phone 318-470-4315
Authorized official
Margaret Michelle Brace McKellar
Owner
3184704315
Is something wrong?
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