Provider Demographics
NPI:1780043026
Name:MCDANIEL, LESTER EARL SR (MHS BS-ED)
Entity Type:Individual
Prefix:
First Name:LESTER
Middle Name:EARL
Last Name:MCDANIEL
Suffix:SR
Gender:M
Credentials:MHS BS-ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 POLK ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71052-2452
Mailing Address - Country:US
Mailing Address - Phone:318-871-5566
Mailing Address - Fax:318-871-1076
Practice Address - Street 1:6007 FINANCIAL PLAZA SUITE 207
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71129
Practice Address - Country:US
Practice Address - Phone:318-621-0910
Practice Address - Fax:318-621-0918
Is Sole Proprietor?:No
Enumeration Date:2016-02-15
Last Update Date:2018-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health