NPIMap

Organization Active NPI

Kelly Liner Derouen, LPC-S, LMFT, NCC, NCSC, Supervisor LLC

  • Professional Counselor
  • Houma, LA
National Provider Identifier
1073530903
Registry record updated Nov 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
KELLY LINER DEROUEN, LPC-S, LMFT, NCC, NCSC, SUPERVISOR LLC
Practice address
547 Bayou Dularge Road
Houma, LA 70363
Phone
(985) 876-5748
NPI assigned
Jul 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2013

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

Authorized official

Name
Ms. Kelly Liner Derouen, LPC-S,LMFT,NCC,NCSC,NPI 1619996519
Title
Counselor
Phone
(985) 876-5748

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X Primary
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X

Addresses

Primary practice location

547 Bayou Dularge Road
Houma, LA 70363

Mailing address

547 Bayou Dularge Road
Houma, LA 70363
Phone (985) 876-5748

Other names 1

  • Kelly Liner Derouen Former legal business name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1385251200000",
    "number": "1073530903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "547 BAYOU DULARGE ROAD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70363",
            "telephone_number": "985-876-5748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "547 BAYOU DULARGE ROAD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "70363",
            "telephone_number": "985-876-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY LINER DEROUEN, LPC-S, LMFT, NCC, NCSC, SUPERVISOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-16",
        "last_updated": "2013-11-24",
        "status": "A",
        "authorized_official_last_name": "DEROUEN",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LINER",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "985-876-5748",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPC-S,LMFT,NCC,NCSC,"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kelly Liner Derouen",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; 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.