Healthcare Provider Details

I. General information

NPI: 1740038314
Provider Name (Legal Business Name): LIVE OUT LOUD COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2924 KNIGHT ST STE 369
SHREVEPORT LA
71105-2413
US

IV. Provider business mailing address

PO BOX 1557
HAUGHTON LA
71037-1557
US

V. Phone/Fax

Practice location:
  • Phone: 318-621-4323
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASHONDA ATKINS
Title or Position: OWNER
Credential: LPC
Phone: 318-560-7308