Basic Information
| Provider Information | |||||||||
| NPI: | 1508924911 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | METROPOLITAN CIRCLES, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3510 LINWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711034512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186364194 | ||||||||
| FaxNumber: | 3186364196 | ||||||||
| Practice Location | |||||||||
| Address1: | 3510 LINWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711034512 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3186364194 | ||||||||
| FaxNumber: | 3186364196 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/05/2006 | ||||||||
| LastUpdateDate: | 11/17/2008 | ||||||||
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| AuthorizedOfficialLastName: | THROWER | ||||||||
| AuthorizedOfficialFirstName: | JAMES | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 3186364194 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | JR. | ||||||||
| AuthorizedOfficialCredential: | LCSW | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 4131 | LA | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Social Worker | Clinical | 261QM0801X | MD022979 | LA | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
No ID Information.