Active NPI
Kissa Underwood, LCDC
- Addiction (Substance Use Disorder) Counselor
- El Paso, TX
National Provider Identifier
1346624830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LCDC 12944
- Practice address
- 1900 Wyoming Ave
Suite B
El Paso, TX 79903-3409 - Phone
- (915) 779-4527
- Fax
- (915) 779-3511
- NPI assigned
- Jul 14, 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LCDC 12944 | TX | Primary |
Addresses
Primary practice location
1900 Wyoming Ave
Suite B
El Paso, TX 79903-3409
Mailing address
1900 Wyoming Ave
Suite B
El Paso, TX 79903-3409
Phone (915) 779-4527
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 |
|---|---|---|---|
| LCDC 12944 | TX | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436832000000",
"number": "1346624830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1900 WYOMING AVE",
"address_2": "SUITE B",
"city": "EL PASO",
"state": "TX",
"postal_code": "799033409",
"telephone_number": "915-779-4527",
"fax_number": "915-779-3511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1900 WYOMING AVE",
"address_2": "SUITE B",
"city": "EL PASO",
"state": "TX",
"postal_code": "799033409",
"telephone_number": "915-779-4527",
"fax_number": "915-779-3511"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "KISSA",
"credential": "LCDC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-07-14",
"last_updated": "2015-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "LCDC 12944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.