PEACE OF MIND FAMILY AND MENTAL HEALTH CLINIC
NPI 1104751411
Family Medicine in Shreveport, LA
About Peace Of Mind Family And Mental Health Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PEACE OF MIND FAMILY AND MENTAL HEALTH CLINIC (NPI 1104751411) is a healthcare organization registered as a family medicine in Shreveport, Louisiana and active in the NPI registry since June 2026. The organization holds a CLIA Waiver certificate valid through July 27, 2028 and lists Otissicia Lateac Hill, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Peace Of Mind Family And Mental Health Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Peace Of Mind Family And Mental Health Clinic, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 19D2347966
Peace Of Mind Family And Mental Health Clinic · Shreveport, LAFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Peace Of Mind Family And Mental Health Clinic's NPI number?
The NPI number for Peace Of Mind Family And Mental Health Clinic is 1104751411. It was assigned to this organization in the NPPES registry on June 17, 2026.
Where is Peace Of Mind Family And Mental Health Clinic located?
Peace Of Mind Family And Mental Health Clinic is located at 2015 E 70th St, Shreveport, LA 71105. The listed phone number is (318) 272-5015.
What is Peace Of Mind Family And Mental Health Clinic's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Peace Of Mind Family And Mental Health Clinic enrolled in Medicare?
Yes. Peace Of Mind Family And Mental Health Clinic is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Peace Of Mind Family And Mental Health Clinic?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Peace Of Mind Family And Mental Health Clinic. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Peace Of Mind Family And Mental Health Clinic hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 19D2347966) is associated with this NPI, valid through July 27, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Peace Of Mind Family And Mental Health Clinic was last updated on June 23, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Peace Of Mind Family And Mental Health Clinic · NPI 1104751411
Family Medicine organization in Shreveport, Louisiana. Organization record, active in the CMS NPPES registry since June 17, 2026.
## Identity
- **NPI:** 1104751411 (Entity type: Organization)
- **Enumerated:** June 17, 2026
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Otissicia Hill, OWNER
## Practice location
- **Address:** 2015 E 70TH ST, Shreveport, LA 71105-5305
- **Phone:** (318) 272-5015
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Nurse Practitioner) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 23, 2026
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104751411) · Data from the CMS NPPES public registry.