MEDICARE: MONIQUE L EDWARDS-LINSTROM PLPC, CRC, MS ED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	PLC10973	LA

General Provider Information

NPI Number	:	1518837681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE L EDWARDS-LINSTROM PLPC, CRC, MS ED

Provider Business Mailing Address
First Line	:	2920 KNIGHT ST STE 155
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-429-6938
Fax Number	:

Provider Business Practice Location Address
First Line	:	2920 KNIGHT ST STE 155
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71105-2412
Country	:	US
Telephone Number	:	318-429-6938
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2025
Last Update Date	:	12/02/2025

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