Kevin Wesley Jeffries, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

16142 Issued in TX

Practice address

715 W 2ND Ave
Corsicana, TX 75110-3012

Phone

(903) 872-4442

Fax

(903) 872-2125

NPI assigned

May 5, 2023

Last updated

May 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Philip R. Taft Psy.D. PLLC

  • Psychologist
  • Corsicana, TX
  • NPI 1366628331
  NPD

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

{
    "created_epoch": "1683244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683244800000",
    "number": "1447949227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MONROE ST",
            "city": "JACKSONVILLE",
            "state": "TX",
            "postal_code": "757664342",
            "telephone_number": "817-291-3235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 W 2ND AVE",
            "city": "CORSICANA",
            "state": "TX",
            "postal_code": "751103012",
            "telephone_number": "903-872-4442",
            "fax_number": "903-872-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEFFRIES",
        "first_name": "KEVIN",
        "middle_name": "WESLEY",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-05-05",
        "last_updated": "2023-05-05",
        "certification_date": "2023-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "16142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alyssa Brooke Janecka, PHARMD
• Courtney Janick
• Jazsa 5, LLC (287 Therapy)
• Julianne Venise Jefferson, LVN
• Jeffrey Petty, DPM, PA (Corsicana Foot Clinic)
• Jenica Senior Transportation Service
• McKenzie Grace Jenkins
• Thomas Joseph Jennings, MD
• Meredith A Johnston, M.D.
• Jones Medical Equipment, Inc.

• Addiction (Substance Use Disorder) Counselor in Corsicana, TX
• Providers in Corsicana, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; 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.