Individual provider Active NPI

Amanda Holmes

  • Mental Health Counselor
  • Lafayette, LA
National Provider Identifier
1114462603
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1304 Bertrand Dr
Buite B2
Lafayette, LA 70506-9107
Phone
(337) 319-1315
NPI assigned
Dec 20, 2016
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

OrganizationSpecialtyStatusNew 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.

Verify at the official NPI Registry.