Kellie Pebbles, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

15289 Issued in LA

Practice address

457 2ND St
Colfax, LA 71417-1807

Phone

(318) 827-4357

Fax

(318) 409-0099

NPI assigned

Feb 9, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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 and National Provider Directory roles.

• Louisiana Behavioral Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colfax, LA
  • NPI 1053936070
  NPD

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

{
    "created_epoch": "1612828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1487246757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13312",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713153312",
            "telephone_number": "318-827-4357",
            "fax_number": "318-409-0099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "457 2ND ST",
            "city": "COLFAX",
            "state": "LA",
            "postal_code": "714171807",
            "telephone_number": "318-827-4357",
            "fax_number": "318-409-0099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEBBLES",
        "first_name": "KELLIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-09",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "LA",
            "license": "15289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie Lemott
• Julianna Brooke Lewis, LOTR
• Louisiana Behavioral Services
• Chasity L Milner
• Office of Public Health/Gphu
• Kande Perkins, CCC-SLP
• Kaycie Posey, AGNP
• Daniel B Reitzell, PHARMD
• Sammy H Reitzell Jr.
• Rachal Russell, RN BSN

• Social Worker in Colfax, LA
• Providers in Colfax, LA by specialty
• Social Worker in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 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.