Active NPI
Roderick Jermaine Lewis
- Mental Health Counselor
- Shreveport, LA
National Provider Identifier
1669992939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 2915 Mackey Lane
Shreveport, LA 71118-0000 - Phone
- (318) 518-9002
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
2915 Mackey Lane
Shreveport, LA 71118-0000
Mailing address
8533 Roitan Dr
Shreveport, LA 71106-5813
Phone (318) 518-9002
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1498521600000",
"number": "1669992939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8533 ROITAN DR",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711065813",
"telephone_number": "318-518-9002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2915 MACKEY LANE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711180000",
"telephone_number": "318-518-9002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "RODERICK",
"middle_name": "JERMAINE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2017-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"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 Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.