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NPI Code Detail

MEDICARE: ARMANDA Y. WHITAKER I

MEDICARE: ARMANDA Y. WHITAKER I
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
1101YM0800XMental Health Counselor11014LA

General Provider Information

NPI Number : 1679797286
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARMANDA Y. WHITAKER I
Provider Business Mailing Address
First Line : 2733 MILLARD ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71108-5044
Country : US
Telephone Number : 318-655-0516
Fax Number :
Provider Business Practice Location Address
First Line : 4571 N MARKET ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71107-2917
Country : US
Telephone Number : 318-424-8735
Fax Number : 318-424-8739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2007
Last Update Date : 01/30/2026

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