Individual provider Active NPI

Christe Hester Pettis, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Lake Charles, LA
National Provider Identifier
1124254578
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
3960 Issued in LA
Practice address
2016 Evelyn St
Lake Charles, LA 70601-6548
Phone
(337) 433-1419
NPI assigned
May 29, 2009
Last updated
Jan 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 3960 LA Primary

Addresses

Primary practice location

2016 Evelyn St
Lake Charles, LA 70601-6548

Mailing address

127 Williamsburg St BLDG E
Lake Charles, LA 70605-5719
Phone (337) 376-0136

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
3960LAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Connections of Southwest LLC CurrentSince Jan 12, 2025 Accepting new patients

Locations

127 Williamsburg St
Bldg E
Lake Charles, LA 70605
Phone (337) 376-0136

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": "1243555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1124254578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 WILLIAMSBURG ST BLDG E",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055719",
            "telephone_number": "337-376-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 EVELYN ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706016548",
            "telephone_number": "337-433-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIS",
        "first_name": "CHRISTE",
        "middle_name": "HESTER",
        "name_prefix": "Mrs.",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-29",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "LA",
            "license": "3960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.