Active NPI
Amanda Holmes
- Mental Health Counselor
- Lafayette, LA
National Provider Identifier
1114462603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 1304 Bertrand Dr
Buite B2
Lafayette, LA 70506-9107 - Phone
- (337) 319-1315
- NPI assigned
- Dec 20, 2016
- Last updated
- Dec 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary | |
| Community/Behavioral Health Agency | 251S00000X | NU |
Addresses
Primary practice location
1304 Bertrand Dr
Buite B2
Lafayette, LA 70506-9107
Mailing address
1304 Bertrand Dr
Buite B2
Lafayette, LA 70506-9107
Phone (337) 319-1315
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Khonsu, LLC | Community/Behavioral Health | Current | Accepting new patients |
Organizations & group practices 1
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": "1482192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1482192000000",
"number": "1114462603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1304 BERTRAND DR",
"address_2": "BUITE B2",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705069107",
"telephone_number": "337-319-1315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1304 BERTRAND DR",
"address_2": "BUITE B2",
"city": "LAFAYETTE",
"state": "LA",
"postal_code": "705069107",
"telephone_number": "337-319-1315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLMES",
"first_name": "AMANDA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-20",
"last_updated": "2016-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Lafayette, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.