NPIMap

Individual provider Active NPI

Kenyatta Avery

  • Counselor
  • Baton Rouge, LA
National Provider Identifier
1083069355
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
9391 Issued in LA
Practice address
4255 E Brookstown Dr
Baton Rouge, LA 70805-4603
Phone
(225) 291-9646
Fax
(225) 250-5677
NPI assigned
Apr 25, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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
Counselor 101Y00000X 9391 LA Primary

Addresses

Primary practice location

4255 E Brookstown Dr
Baton Rouge, LA 70805-4603

Mailing address

4255 E Brookstown Dr
Baton Rouge, LA 70805-4603
Phone (225) 250-5677

Other practice location 1

1200 S Acadian Thruway
Baton Rouge, LA 70806-6900
Phone (225) 831-4997

Other identifiers 1

IdentifierTypeStateIssuer
600751961MedicaidLA

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
9391LAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Outreach Services LLC Past Accepting new patients
Novice House of Baton Rouge, Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1083069355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708054603",
            "telephone_number": "225-250-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 E BROOKSTOWN DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708054603",
            "telephone_number": "225-291-9646",
            "fax_number": "225-250-5677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 S Acadian Thruway",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708066900",
            "country_code": "US",
            "telephone_number": "225-831-4997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AVERY",
        "first_name": "KENYATTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-25",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "9391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600751961",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2025; 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.