Individual provider Active NPI

Keara Ndhlovu, LMSW

  • Addiction (Substance Use Disorder) Counselor
  • Aiken, SC
National Provider Identifier
1194178012
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
11792 LMSW Issued in SC
Practice address
1105 Gregg Hwy NW
Aiken, SC 29801-6341
Phone
(803) 649-1900
Fax
(803) 643-2926
NPI assigned
Jul 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 11792 LMSW SC
Addiction (Substance Use Disorder) Counselor 101YA0400X 11792 LMSW SC Primary

Addresses

Primary practice location

1105 Gregg Hwy NW
Aiken, SC 29801-6341

Mailing address

1105 Gregg Hwy NW
Aiken, SC 29801-6341
Phone (803) 649-1900

Other identifiers 2

IdentifierTypeStateIssuer
AD01AKMedicaidSC
570569761OtherSCTAX ID

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

State licenses

LicenseStateTypeSpecialty
11792 LMSWSCMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1468540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468540800000",
    "number": "1194178012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 GREGG HWY NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016341",
            "telephone_number": "803-649-1900",
            "fax_number": "803-643-2926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 GREGG HWY NW",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298016341",
            "telephone_number": "803-649-1900",
            "fax_number": "803-643-2926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NDHLOVU",
        "first_name": "KEARA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-15",
        "last_updated": "2016-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "SC",
            "license": "11792 LMSW",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SC",
            "license": "11792 LMSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AD01AK",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "570569761",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.