Active NPI
Kathleen Rose Canterbury
- Addiction (Substance Use Disorder) Counselor
- Lake Charles, LA
National Provider Identifier
1285104539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 4161
- Practice address
- 145 Victoria Dr
Lake Charles, LA 70611-4641 - Phone
- (337) 855-9773
- NPI assigned
- Nov 29, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 4161 | LA | Primary |
Addresses
Primary practice location
145 Victoria Dr
Lake Charles, LA 70611-4641
Mailing address
145 Victoria Dr
Lake Charles, LA 70611-4641
Phone (337) 855-9773
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
| License | State | Type | Specialty |
|---|---|---|---|
| 4161 | LA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543449600000",
"number": "1285104539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "145 VICTORIA DR",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706114641",
"telephone_number": "337-855-9773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "145 VICTORIA DR",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706114641",
"telephone_number": "337-855-9773"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANTERBURY",
"first_name": "KATHLEEN",
"middle_name": "ROSE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-11-29",
"last_updated": "2018-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "LA",
"license": "4161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.