Individual provider Active NPI

Kevin Smithey, LAC, PLPC

  • Addiction (Substance Use Disorder) Counselor
  • Bossier City, LA
National Provider Identifier
1720584154
Registry record updated Mar 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1605 Benton Rd Ste D
Bossier City, LA 71111-3579
Phone
(318) 742-0500
NPI assigned
Apr 4, 2018
Last updated
Mar 16, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU Primary

Addresses

Primary practice location

1605 Benton Rd Ste D
Bossier City, LA 71111-3579

Mailing address

829 Audubon PL
Shreveport, LA 71105-2812
Phone (318) 269-5913

Other practice location 1

8504 Line Ave
Shreveport, LA 71106-6146
Phone (318) 269-5913

Other identifiers 1

IdentifierTypeStateIssuer
3969670MedicaidLA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Magnolia Recovery, LLC CurrentSince Jul 4, 2021 Accepting new patients
Magnolia Recovery, LLC Addiction (Substance Use Disorder) CurrentSince May 28, 2023 Accepting new patients

Locations

3605 Youree Dr
Shreveport, LA 71105
Phone (318) 615-9006

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773619200000",
    "number": "1720584154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "829 AUDUBON PL",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711052812",
            "telephone_number": "318-269-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 BENTON RD STE D",
            "city": "BOSSIER CITY",
            "state": "LA",
            "postal_code": "711113579",
            "telephone_number": "318-742-0500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8504 Line Ave",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711066146",
            "country_code": "US",
            "telephone_number": "318-269-5913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SMITHEY",
        "first_name": "KEVIN",
        "credential": "LAC, PLPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-04",
        "last_updated": "2026-03-16",
        "certification_date": "2026-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3969670",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bossier City, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2026; 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.