Khonsu, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

KHONSU, LLC

Practice address

3419 NW Evangeline Trwy Ste a-1
Carencro, LA 70520-6241

Phone

(337) 319-1315

NPI assigned

Jan 23, 2018

Organization subpart

No

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

Authorized official

Name

Amanda Lee HolmesNPI 1114462603

Title

Owner

Phone

(337) 345-5390

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Amanda Holmes

  • Mental Health Counselor
  • Lafayette, LA
  • NPI 1114462603

  Community/Behavioral Health

  NPD Authorized official

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

{
    "created_epoch": "1516665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611273600000",
    "number": "1386142545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 NW EVANGELINE TRWY STE A-1",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "705206241",
            "telephone_number": "337-319-1315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 NW EVANGELINE TRWY STE A-1",
            "city": "CARENCRO",
            "state": "LA",
            "postal_code": "705206241",
            "telephone_number": "337-319-1315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KHONSU, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-23",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "337-345-5390"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Reaux Johnson, LOTR
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• Valerie A Labbe, LOTR
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• Aaron T Lafleur, DPT

• Professional Counselor in Carencro, LA
• Providers in Carencro, LA by specialty
• Professional Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2021; 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.