Shelly Killingsworth, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6643

Practice address

118 Exchange PL
Lafayette, LA 70503-2510

Phone

(337) 789-0442

Fax

(337) 345-1576

NPI assigned

Jun 27, 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

Master of Science

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.

• Worth Counseling Group

  • Mental Health Counselor
  • Lafayette, LA
  • NPI 1790330546
  NPD Authorized official

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

{
    "created_epoch": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1225489776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 TEAKWOOD DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925223",
            "telephone_number": "337-789-0442",
            "fax_number": "337-345-1576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 EXCHANGE PL",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032510",
            "telephone_number": "337-789-0442",
            "fax_number": "337-345-1576"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 N Parkerson Ave",
            "address_purpose": "LOCATION",
            "city": "Crowley",
            "state": "LA",
            "postal_code": "705265046",
            "country_code": "US",
            "telephone_number": "337-514-5181",
            "fax_number": "337-514-5182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KILLINGSWORTH",
        "first_name": "SHELLY",
        "name_prefix": "Mrs.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-27",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": "6643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kidzz Urgent Care, LLC
• Micki S. Kieta, CRNA
• Morgan Vidrine Kigerl
• Laura Lee Kight, NURSE PRACTITIONER
• Daniel Killian, LPC
• Kim a Hardey a Professional Medical Corporation
• Kim Thomas Judice, DDS Family Dentistry
• Kyu Won Kim, RPH
• Baylen Gregory Kimball, M.D.
• Daniel J Kimball, LCSW

• Mental Health Counselor in Lafayette, LA
• Providers in Lafayette, 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 Mar 25, 2020; 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.