Provider Demographics
NPI:1417302837
Name:MCNEAR, KHARHYZMA (MHP)
Entity Type:Individual
Prefix:
First Name:KHARHYZMA
Middle Name:
Last Name:MCNEAR
Suffix:
Gender:F
Credentials:MHP
Other - Prefix:
Other - First Name:KHARHYZMA
Other - Middle Name:K
Other - Last Name:NELSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2800 YOUREE DR STE 120
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71104-3667
Mailing Address - Country:US
Mailing Address - Phone:318-562-6273
Mailing Address - Fax:318-562-6263
Practice Address - Street 1:850 KALISTE SALOOM RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70508-4230
Practice Address - Country:US
Practice Address - Phone:337-234-7109
Practice Address - Fax:337-234-7789
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-04
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1467745000OtherNPI