Charlotte Ivy, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Practice address

1921 Dulles Dr
Lafayette, LA 70506-2716

Phone

(337) 223-9487

Fax

(888) 511-5650

NPI assigned

Jan 27, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Fresh Start Psychiatric Clinic

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1427666353
  NPD

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

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613779200000",
    "number": "1164013876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9843 BLAINE LAKE DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770862878",
            "telephone_number": "337-257-9065",
            "fax_number": "888-511-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1921 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705062716",
            "telephone_number": "337-223-9487",
            "fax_number": "888-511-5650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "CHARLOTTE",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-02-20",
        "certification_date": "2021-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERN NUMBER",
            "identifier": "12345678999966655525",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PLC6505",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Istre Lagasse
• Joshua Istre
• Andrew Iteghie, O.D.
• Ria Itty, M.D.
• Shannen Ivey, APRN-CNP
• Spring Breanna Ivy
• J & J RX Network LLC
• J & J RX Network LLC
• J Patrick Herrington MD LTD
• J. Provost LLC (a Professional Chiropractic Corporation)

• Professional Counselor in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2021; 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.