Active NPI
Thomas Willis Jr., CAC
- Addiction (Substance Use Disorder) Counselor
- West Monroe, LA
National Provider Identifier
1063862175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1544
- Practice address
- 1416 Natchitoches St
West Monroe, LA 71292-3751 - Phone
- (318) 855-8773
- Fax
- (318) 855-8779
- NPI assigned
- Jun 20, 2016
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1544 | LA | Primary |
Addresses
Primary practice location
1416 Natchitoches St
West Monroe, LA 71292-3751
Mailing address
1416 Natchitoches St
West Monroe, LA 71292-3751
Phone (318) 855-8773
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 |
|---|---|---|---|
| 1544 | LA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1466380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1466380800000",
"number": "1063862175",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1416 NATCHITOCHES ST",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712923751",
"telephone_number": "318-855-8773",
"fax_number": "318-855-8779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1416 NATCHITOCHES ST",
"city": "WEST MONROE",
"state": "LA",
"postal_code": "712923751",
"telephone_number": "318-855-8773",
"fax_number": "318-855-8779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIS",
"first_name": "THOMAS",
"name_suffix": "Jr.",
"credential": "CAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-06-20",
"last_updated": "2016-06-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "1544",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Monroe, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.