Healthcare Provider Details

I. General information

NPI: 1518837681
Provider Name (Legal Business Name): MONIQUE L EDWARDS-LINSTROM PLPC, CRC, MS ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2920 KNIGHT ST STE 155
SHREVEPORT LA
71105-2412
US

IV. Provider business mailing address

2920 KNIGHT ST STE 155
SHREVEPORT LA
71105-2412
US

V. Phone/Fax

Practice location:
  • Phone: 318-429-6938
  • Fax:
Mailing address:
  • Phone: 318-429-6938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberPLC10973
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: