Healthcare Provider Details

I. General information

NPI: 1134918667
Provider Name (Legal Business Name): ADDISON C ASCHBACHER PLPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3018 OLD MINDEN RD STE 1200
BOSSIER CITY LA
71112-2476
US

IV. Provider business mailing address

901 DALZELL ST APT A
SHREVEPORT LA
71104-2164
US

V. Phone/Fax

Practice location:
  • Phone: 318-224-7223
  • Fax:
Mailing address:
  • Phone: 817-320-1314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10919
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberR-15622
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: