Active NPI
Kesamyn Sovulewski, LCPC, LCADC
- Mental Health Counselor
- Reno, NV
National Provider Identifier
1053968214
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CP5141
- Practice address
- 615 Riverside Dr
Reno, NV 89503-5601 - Phone
- (406) 579-0410
- NPI assigned
- Aug 22, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 06305-LC | NV | |
| Mental Health Counselor | 101YM0800X | CP5141 | NV | Primary |
Addresses
Primary practice location
615 Riverside Dr
Reno, NV 89503-5601
Mailing address
615 Riverside Dr
Reno, NV 89503-5601
Phone (406) 579-0410
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 |
|---|---|---|---|
| 06305-LC | NV | MD | Addiction (Substance Use Disorder) Counselor |
| CP5141 | NV | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1566432000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706745600000",
"number": "1053968214",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 RIVERSIDE DR",
"city": "RENO",
"state": "NV",
"postal_code": "895035601",
"telephone_number": "406-579-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 RIVERSIDE DR",
"city": "RENO",
"state": "NV",
"postal_code": "895035601",
"telephone_number": "406-579-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOVULEWSKI",
"first_name": "KESAMYN",
"credential": "LCPC, LCADC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-08-22",
"last_updated": "2024-02-01",
"certification_date": "2024-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NV",
"license": "06305-LC",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NV",
"license": "CP5141",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.