Individual provider Active NPI

Desire' Nweke-Roberson, LPC

  • Professional Counselor
  • Lake Charles, LA
National Provider Identifier
1104373026
Registry record updated Aug 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
8324 Issued in LA
Practice address
1925 Enterprise Blvd
Lake Charles, LA 70601-6371
Phone
(337) 429-5129
NPI assigned
Sep 8, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Case Manager/Care Coordinator 171M00000X
Professional Counselor 101YP2500X 8324 LA Primary

Addresses

Primary practice location

1925 Enterprise Blvd
Lake Charles, LA 70601-6371

Mailing address

1925 Enterprise Blvd
Lake Charles, LA 70601-6371
Phone (337) 429-5129

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240904001905 LA Practitioner - Mental Health Counselor 0143760264 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8324LAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Health Services LLC CurrentSince Jul 12, 2024 Accepting new patients
Resolutions Counseling Services Professional CurrentSince Aug 6, 2023 Accepting new patients

Locations

1925 Enterprise Blvd
Lake Charles, LA 70601
Phone (337) 429-5129

1639 Ryan St
Lake Charles, LA 70601
Phone (337) 602-6391

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691107200000",
    "number": "1104373026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 ENTERPRISE BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706016371",
            "telephone_number": "337-429-5129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 ENTERPRISE BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706016371",
            "telephone_number": "337-429-5129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NWEKE-ROBERSON",
        "first_name": "DESIRE'",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-08",
        "last_updated": "2023-08-04",
        "certification_date": "2021-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "8324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.