Healthcare Provider Details

I. General information

NPI: 1588858104
Provider Name (Legal Business Name): COMPREHENSIVE ASSESSMENTS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2007
Last Update Date: 11/05/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4300 YOUREE DR SUITE 200 BUILDING 2
SHREVEPORT LA
71105-3329
US

IV. Provider business mailing address

4300 YOUREE DR SUITE 200 BUILDING 2
SHREVEPORT LA
71105-3329
US

V. Phone/Fax

Practice location:
  • Phone: 318-861-0194
  • Fax: 318-861-0284
Mailing address:
  • Phone: 318-861-0194
  • Fax: 318-861-0284

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number254
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number254
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number254
License Number StateLA

VIII. Authorized Official

Name: DR. THOMAS E STAATS
Title or Position: OWNER
Credential: PH.D
Phone: 318-861-0194