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General NPI Number Information
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NPI Number | 1558506840
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Entity Type | Individual
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Provider Name | JOHN KEVIN ALDERMAN LPC
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Gender | Male
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Dates
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Enumeration Date | 12/16/2008
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 820 JORDAN ST SUITE 510A
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City | SHREVEPORT
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State | LA
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Zip | 71101-4518
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Country | US
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Telephone | 318-560-0972
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Fax | 318-226-6942
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Provider Business Mailing Address
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Address Line | 12410 RUST LN
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City | KEITHVILLE
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State | LA
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Zip | 71047-9587
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Country | US
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Telephone | 318-560-0972
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Fax | 318-226-6942
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3739
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License Number State | LA
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