Active NPI
Amy Mathews Creel, LPC
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1639222888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2402
- Practice address
- 1310 N Hearne Ave
Shreveport, LA 71107-6516 - Phone
- (318) 676-5111
- Fax
- (318) 676-5077
- NPI assigned
- Jan 19, 2007
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2402 | LA | Primary |
Addresses
Primary practice location
1310 N Hearne Ave
Shreveport, LA 71107-6516
Mailing address
8674 Jackson Square PL
Shreveport, LA 71115-2726
Phone (318) 798-9266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8686 | Other | LA | OMH PROVIDER NUMBER |
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 |
|---|---|---|---|
| 2402 | LA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1639222888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8674 JACKSON SQUARE PL",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711152726",
"telephone_number": "318-798-9266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1310 N HEARNE AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711076516",
"telephone_number": "318-676-5111",
"fax_number": "318-676-5077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CREEL",
"first_name": "AMY",
"middle_name": "MATHEWS",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "2402",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OMH PROVIDER NUMBER",
"identifier": "8686",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Shreveport, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.