Active NPI
Mary Kristina Jones Tew
- Mental Health Counselor
- Norco, LA
National Provider Identifier
1023568458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CI 5431
- Practice address
- 626 5TH St
Norco, LA 70079-2308 - Phone
- (601) 447-7188
- NPI assigned
- Oct 10, 2016
- Last updated
- Oct 10, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CI 5431 | MS | Primary |
Addresses
Primary practice location
626 5TH St
Norco, LA 70079-2308
Mailing address
PO Box 57
Norco, LA 70079-0057
Phone (601) 447-7188
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CI 5431 | MS | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476057600000",
"number": "1023568458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 57",
"city": "NORCO",
"state": "LA",
"postal_code": "700790057",
"telephone_number": "601-447-7188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "626 5TH ST",
"city": "NORCO",
"state": "LA",
"postal_code": "700792308",
"telephone_number": "601-447-7188"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TEW",
"first_name": "MARY",
"middle_name": "KRISTINA JONES",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-10",
"last_updated": "2016-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MS",
"license": "CI 5431",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norco, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.