Organization
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Active
Parent organization
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Other names
CHI - Caddo
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNCIL FOR ADVANCEMENT OF SOCIAL SERVICE AND EDUCATION
Authorized official
MRS. MARY MADDEN CHUMLEY (EXECUTIVE DIRECTOR)
(318) 688-3350
Entity
Organization
Contact information
Practice address
2120 BERT KOUNS INDUSTRIAL LOOP STE B, SHREVEPORT, LA 71118-3351
(318) 688-3350
(318) 688-3655
Mailing address
2120 BERT KOUNS INDUSTRIAL LOOP STE A, SHREVEPORT, LA 71118-3351
(318) 688-3350
(318) 688-3655
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
104100000X
Social Worker
—
—
1223G0001X
General Practice Dentistry
Primary
3665
LA
208D00000X
General Practice Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1452769
—
LA
01
—
455678
UNITED CONCORDIA INS.
—
01
—
C8303
BLUE CROSS/BLUE SHIELD LA
LA
Enumeration date
11/01/2006
Last updated
10/18/2023
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