Individual provider Active NPI

Keith McPherson Ennis, SUDC III-CS

  • Addiction (Substance Use Disorder) Counselor
  • Fresno, CA
National Provider Identifier
1356714430
Registry record updated Sep 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
6533 Issued in CA
Practice address
3636 N 1St St Ste 135&154
Fresno, CA 93726-6800
Phone
(559) 225-1464
Fax
(844) 601-2973
NPI assigned
Nov 11, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 6533 CA Primary

Addresses

Primary practice location

3636 N 1St St Ste 135&154
Fresno, CA 93726-6800

Mailing address

3636 N. First St. # 135
Fresno, CA 93726
Phone (559) 225-1464

Other practice location 1

1204 W Shaw Ave Ste 102
Fresno, CA 93711-3706
Phone (559) 940-2917

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

LicenseStateTypeSpecialty
6533CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Turning Point of Central California Inc. PastSince Oct 5, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1447200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759104000000",
    "number": "1356714430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3636 N. FIRST ST. # 135",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "93726",
            "telephone_number": "559-225-1464",
            "fax_number": "559-225-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3636 N 1ST ST STE 135&154",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937266800",
            "telephone_number": "559-225-1464",
            "fax_number": "844-601-2973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1204 W Shaw Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937113706",
            "country_code": "US",
            "telephone_number": "559-940-2917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ENNIS",
        "first_name": "KEITH",
        "middle_name": "MCPHERSON",
        "name_prefix": "Mr.",
        "credential": "SUDC III-CS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-11",
        "last_updated": "2025-09-29",
        "certification_date": "2025-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "6533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.