Kimberly Willis Clay

Primary specialty

CounselorTaxonomy code 101Y00000X

License

8749 Issued in LA

Practice address

516 S Martin Luther King Jr Dr
Saint Martinville, LA 70582-3102

Phone

(337) 427-8710

NPI assigned

May 18, 2016

Last updated

Nov 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Beyond the Heart Counseling and Consulting

  • Mental Health Counselor
  • Saint Martinville, LA
  • NPI 1023893195
  NPD Authorized official
• Fairway Counseling Agency, Inc.

  dba Phoenix Family Life Centers

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Alexandria, LA
  • NPI 1912281031
  NPD (past)

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700006400000",
    "number": "1659728764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1137 S BERNARD RD",
            "address_2": "STE. A PMB#1012",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "705183388",
            "telephone_number": "337-427-8710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "516 S MARTIN LUTHER KING JR DR",
            "city": "SAINT MARTINVILLE",
            "state": "LA",
            "postal_code": "705823102",
            "telephone_number": "337-427-8710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLAY",
        "first_name": "KIMBERLY",
        "middle_name": "WILLIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2023-11-15",
        "certification_date": "2023-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "93013",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "LA",
            "license": "8749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1467745000",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Cascio, MSN, RN, CCM, LNCC
• CDJ Rehabilitation Services, LLC
• Lona J Champagne, LCSW
• Change & Healing in Counseling Specialty Group, LLC
• Chariot Transit LLC
• Lasheria Meshali Cola
• Community Care Center of St Martinville LLC (Landmark of Acadiana)
• Bianca Cormier, BA
• Keenen Cormier
• Abigail Naquin Courville, MS, CCC-SLP

• Counselor in Saint Martinville, LA
• Providers in Saint Martinville, LA by specialty
• Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 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.