Provider Demographics
NPI:1326738220
Name:SW SENTELL LLC
Entity Type:Organization
Organization Name:SW SENTELL LLC
Other - Org Name:DR. SENTELL & ASS.
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATIVE
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SENTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-868-2001
Mailing Address - Street 1:8504 LINE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-6146
Mailing Address - Country:US
Mailing Address - Phone:318-868-2001
Mailing Address - Fax:318-675-1517
Practice Address - Street 1:8504 LINE AVE
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-6146
Practice Address - Country:US
Practice Address - Phone:318-868-2001
Practice Address - Fax:318-675-1517
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-12
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty