Individual provider Active NPI

Adam Kershaw, PLPC

  • Professional Counselor
  • Lafayette, LA
National Provider Identifier
1063111607
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PLC9269 Issued in LA
Practice address
302 Dulles Dr
Lafayette, LA 70506-3008
Phone
(337) 262-4100
NPI assigned
Mar 2, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X PLC9269 LA
Professional Counselor 101YP2500X PLC9269 LA Primary

Addresses

Primary practice location

302 Dulles Dr
Lafayette, LA 70506-3008

Mailing address

19157 Crowley Eunice Hwy
Crowley, LA 70526-0801
Phone (337) 514-2101

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

LicenseStateTypeSpecialty
PLC9269LAMDProfessional Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1677715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1063111607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19157 CROWLEY EUNICE HWY",
            "city": "CROWLEY",
            "state": "LA",
            "postal_code": "705260801",
            "telephone_number": "337-514-2101",
            "fax_number": "337-514-2105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063008",
            "telephone_number": "337-262-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERSHAW",
        "first_name": "ADAM",
        "credential": "PLPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-02",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "LA",
            "license": "PLC9269",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "PLC9269",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 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.

Verify at the official NPI Registry.