Provider Demographics
NPI:1558506840
Name:ALDERMAN, JOHN KEVIN (LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:KEVIN
Last Name:ALDERMAN
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
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Mailing Address - Street 1:12410 RUST LN
Mailing Address - Street 2:
Mailing Address - City:KEITHVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:71047-9587
Mailing Address - Country:US
Mailing Address - Phone:318-560-0972
Mailing Address - Fax:318-226-6942
Practice Address - Street 1:820 JORDAN ST
Practice Address - Street 2:SUITE 510A
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4518
Practice Address - Country:US
Practice Address - Phone:318-560-0972
Practice Address - Fax:318-226-6942
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2012-10-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA3739101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional