Individual provider Active NPI

Letricia A Ogutu

  • Mental Health Counselor
  • Decatur, AL
National Provider Identifier
1700022167
Registry record updated Apr 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4110 Highway 31
Decatur, AL 35603-1644
Phone
(256) 355-6105
NPI assigned
Jan 6, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4110 Highway 31
Decatur, AL 35603-1644

Mailing address

1316 Somerville Rd SE
Suite 1
Decatur, AL 35601-4305
Phone (256) 355-6105

Other identifiers 1

IdentifierTypeStateIssuer
51134585OtherALBLUE CROSS BLUE SHIELD OF AL

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": "1231200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365984000000",
    "number": "1700022167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1316 SOMERVILLE RD SE",
            "address_2": "SUITE 1",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356014305",
            "telephone_number": "256-355-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 HIGHWAY 31",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031644",
            "telephone_number": "256-355-6105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGUTU",
        "first_name": "LETRICIA",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-06",
        "last_updated": "2013-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF AL",
            "identifier": "51134585",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2013; 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.