Etta Kemyata Brown, LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2020 E 70TH St Ste 201
Shreveport, LA 71105-5332

Phone

(318) 751-9098

NPI assigned

Aug 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Mental Health Counselor

Education

William Carey University College of Osteopathic Medicine, 2015

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Authentic Minds, LLC

  • Professional Counselor
  • Atlanta, GA
  • NPI 1275104291
  NPD Authorized official
• Assertive Community Recovery, LLC

  • Community/Behavioral Health Agency
  • Decatur, GA
  • NPI 1265607683
  Medicare reassignment
• Elated Counseling Services LLC

  • Mental Health Counselor
  • Shreveport, LA
  • NPI 1548760671
  NPD

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

{
    "created_epoch": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625788800000",
    "number": "1245710367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 VILLAGGIO BLVD.",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711117459",
            "telephone_number": "601-698-4172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 70TH ST STE 201",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055332",
            "telephone_number": "318-751-9098"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2306 VILLAGGIO BLVD.",
            "address_purpose": "LOCATION",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711117459",
            "country_code": "US",
            "telephone_number": "601-698-4172",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ETTA",
        "middle_name": "KEMYATA",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2021-07-09",
        "certification_date": "2021-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "84782",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Brown, D.C.
• Donna Brown, RRT
• Elaine Holtzman Brown
• Elischa Brown, FNP
• Erin D Brown
• Francine Brown
• Gregory James Brown, M.D.
• Herschel Brown, PHARM D
• Ida Brown
• Inita Brown, MS

• Mental Health Counselor in Shreveport, LA
• Providers in Shreveport, 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 Jul 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.