MEDICARE: SW SENTELL LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	251S00000X	Community/Behavioral Health Agency
2	101YP2500X	Professional Counselor
3	103TC0700X	Clinical Psychologist

General Provider Information

NPI Number	:	1326738220
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SW SENTELL LLC

Provider Business Mailing Address
First Line	:	8504 LINE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-6146
Country	:	US
Telephone Number	:	318-868-2001
Fax Number	:	318-675-1517

Provider Business Practice Location Address
First Line	:	8504 LINE AVE
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-6146
Country	:	US
Telephone Number	:	318-868-2001
Fax Number	:	318-675-1517

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUEL WEBB SENTELL
Credential	:
Telephone Number	:	318-675-1515

Provider Enumeration Date	:	05/12/2023
Last Update Date	:	05/27/2026

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Directions to “SW SENTELL LLC ” Practice Location

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