Healthcare Provider Details

I. General information

NPI: 1912815515
Provider Name (Legal Business Name): HEATHER GOODMAN-D'ANNA, MA, LPC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 GILBERT DR STE 110
SHREVEPORT LA
71104-5000
US

IV. Provider business mailing address

1509 SUBURBIA DR
SHREVEPORT LA
71105-5021
US

V. Phone/Fax

Practice location:
  • Phone: 318-963-0029
  • Fax:
Mailing address:
  • Phone: 318-450-5646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MISS HEATHER DENESE GOODMAN
Title or Position: OWNER/ADMIN/PROVIDER
Credential: LPC
Phone: 318-450-5646