Active NPI
Marilyn Ezell, LPC
- Mental Health Counselor
- Ruston, LA
National Provider Identifier
1336523026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 3502
- Practice address
- 904 Deville LN
Ruston, LA 71270-6313 - Phone
- (318) 255-5575
- Fax
- (318) 255-5457
- NPI assigned
- Jul 13, 2015
- Last updated
- Jul 13, 2015
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 3502 | LA | Primary |
Addresses
Primary practice location
904 Deville LN
Ruston, LA 71270-6313
Mailing address
904 Deville LN
Ruston, LA 71270-6313
Phone (318) 255-5575
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436745600000",
"number": "1336523026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "904 DEVILLE LN",
"city": "RUSTON",
"state": "LA",
"postal_code": "712706313",
"telephone_number": "318-255-5575",
"fax_number": "318-255-5457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "904 DEVILLE LN",
"city": "RUSTON",
"state": "LA",
"postal_code": "712706313",
"telephone_number": "318-255-5575",
"fax_number": "318-255-5457"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EZELL",
"first_name": "MARILYN",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-13",
"last_updated": "2015-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "LA",
"license": "3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ruston, LA
- Exceptional Client Care Services II
- Exceptional Client Care Services II L.L.C
- Execeptional Client Care Services II
- Exectional Client Care Services
- Eye Care & Cosmetic Center, LLC (Williamson Allemond Regional Eye Center)
- Faith in the Family
- Misty Cheek Falting
- Family First Medicine, Apmc
- Family Life Developmental Center
- Family Life Developmental Center
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.