Aliciah Kae Souza, B.S.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

471411453 Issued in LA

Practice address

644 E Jefferson Ave
Bastrop, LA 71220-4619

Phone

(318) 239-3862

Fax

(318) 239-3867

NPI assigned

Nov 4, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

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

{
    "created_epoch": "1478217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478217600000",
    "number": "1154873388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 E PECAN AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712205124",
            "telephone_number": "310-974-3055",
            "fax_number": "318-239-3867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "644 E JEFFERSON AVE",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712204619",
            "telephone_number": "318-239-3862",
            "fax_number": "318-239-3867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUZA",
        "first_name": "ALICIAH",
        "middle_name": "KAE",
        "credential": "B.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-04",
        "last_updated": "2016-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "471411453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bastrop, LA
• Providers in Bastrop, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 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.