Kezia Vida Kamenetz

Key facts

NPI

1275425613

Entity type

Individual (NPI type 1)

Primary specialty

Mental Health Counselor 101YM0800X

License

PLC10570 (LA)

Practice address

40 Biscarner Rd
Lumberton, MS 39455-4509

Phone

(917) 673-5807

NPI assigned

Jul 18, 2025

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 18, 2025.

{
    "created_epoch": "1752796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1275425613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 BISCARNER RD",
            "city": "LUMBERTON",
            "state": "MS",
            "postal_code": "394554509",
            "telephone_number": "917-673-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 BISCARNER RD",
            "city": "LUMBERTON",
            "state": "MS",
            "postal_code": "394554509",
            "telephone_number": "917-673-5807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMENETZ",
        "first_name": "KEZIA",
        "middle_name": "VIDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-18",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "PLC10570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Lumberton, MS · Mental Health Counselor in Mississippi