MEDICARE: KANEISHA RA-SHAWN HARPER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	164X00000X	Licensed Vocational Nurse	250584	LA
4	101YP1600X	Pastoral Counselor

General Provider Information

NPI Number	:	1295098234
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KANEISHA RA-SHAWN HARPER

Provider Business Mailing Address
First Line	:	9111 INTERLINE AVE STE 8A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1979
Country	:	US
Telephone Number	:	225-442-4818
Fax Number	:

Provider Business Practice Location Address
First Line	:	9111 INTERLINE AVE STE 8A
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70809-1979
Country	:	US
Telephone Number	:	225-442-4818
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2012
Last Update Date	:	01/08/2026

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