Provider Demographics
NPI:1760151245
Name:JAMES, MICAH (LPC)
Entity Type:Individual
Prefix:
First Name:MICAH
Middle Name:
Last Name:JAMES
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SOUTHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2219
Mailing Address - Country:US
Mailing Address - Phone:318-869-1632
Mailing Address - Fax:318-869-1633
Practice Address - Street 1:707 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2219
Practice Address - Country:US
Practice Address - Phone:318-869-1632
Practice Address - Fax:318-869-1633
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2022-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAPLC8026101YM0800X
LA8026101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health