Individual provider Active NPI

Miyokia Carter

  • Professional Counselor
  • Thibodaux, LA
National Provider Identifier
1063956076
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7296 Issued in LA
Practice address
114 Palm Villa
Apt1
Thibodaux, LA 70301-4200
Phone
(985) 232-8449
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 7296 LA
School Counselor 101YS0200X
Professional Counselor 101YP2500X 7296 LA Primary

Addresses

Primary practice location

114 Palm Villa
Apt1
Thibodaux, LA 70301-4200

Mailing address

114 Palm Villa
Apt1
Thibodaux, LA 70301-4200
Phone (985) 232-8449

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
7296LAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Again Therapeutic Services Current Accepting new patients
Revive Again Support Coordination Services LLC Current Accepting new patients

Locations

231 W Cornerview St
Gonzales, LA 70737
Phone (225) 399-3147

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592179200000",
    "number": "1063956076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 PALM VILLA",
            "address_2": "APT1",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014200",
            "telephone_number": "985-232-8449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 PALM VILLA",
            "address_2": "APT1",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014200",
            "telephone_number": "985-232-8449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARTER",
        "first_name": "MIYOKIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "7296",
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "7296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2020; 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.