Individual provider Active NPI

Cedrina Knight Averette, PHD

  • Counseling Psychologist
  • Lafayette, LA
National Provider Identifier
1124520309
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
1397 Issued in LA
Practice address
3312 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-7449
Phone
(337) 534-0727
Fax
(337) 534-0737
NPI assigned
Mar 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X 1397 LA Primary

Addresses

Primary practice location

3312 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-7449

Mailing address

3312 Kaliste Saloom Rd BLDG 1
Lafayette, LA 70508-7449
Phone (337) 534-0727

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
I20180522001377 LA Practitioner - Clinical Psychologist 6103181102 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3312 Kaliste Saloom Rd
Suite 1
Lafayette, LA 70508-7449
Phone (337) 534-0727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1397LAMDCounseling Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Averette Psychological Services Counseling CurrentSince Jul 1, 2023 Accepting new patients

Locations

141 Ridgeway Dr
Ste 102
Lafayette, LA 70503
Phone (337) 806-8783

3312 Kaliste Saloom Rd
#1
Lafayette, LA 70508
Phone (337) 534-0727

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1520208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690761600000",
    "number": "1124520309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3312 KALISTE SALOOM RD BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087449",
            "telephone_number": "337-534-0727",
            "fax_number": "337-534-0737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3312 KALISTE SALOOM RD BLDG 1",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705087449",
            "telephone_number": "337-534-0727",
            "fax_number": "337-534-0737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERETTE",
        "first_name": "CEDRINA",
        "middle_name": "KNIGHT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-03-05",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "LA",
            "license": "1397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.