Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Albert Fullwood Sr.

Individual provider Mental Health Counselor · NPI 1194270405

Albert Fullwood Sr. is a Mental Health Counselor in Shreveport, Louisiana. Practices as a sole proprietor. Licensed in Louisiana.

Licensed in
LA
In the registry since
2016
Specialties on file
3
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Practice location Address checks out

6015 Hearne Ave
Shreveport, LA 71108-3803
Phone: (318) 213-0904
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Social Worker (primary) Taxonomy 104100000X · Licence 16059 (LA)
Mental Health Counselor Taxonomy 101YM0800X · Licence 600720427 (LA)
Case Manager/Care Coordinator Taxonomy 171M00000X · Licence 16059 (LA)

Record details

NPI number1194270405
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedAugust 17, 2016
Last updated in NPPESAugust 13, 2024
Certification dateAugust 13, 2024

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