NPIMap

Organization Active NPI

Jacquelyn Kirby Counseling & Consulting, LLC

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1770017097
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
5034 Issued in LA
Legal business name
JACQUELYN KIRBY COUNSELING & CONSULTING, LLC
Practice address
2020 E 70TH St Ste 301
Shreveport, LA 71105-5332
Phone
(318) 564-2493
Fax
(318) 300-3983
NPI assigned
Apr 13, 2017
Last updated
Mar 17, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Authorized official

Name
Mrs. Jacquelyn Kirby, LPCNPI 1932644085
Title
Counselor/Owner
Phone
(318) 564-2493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 5034 LA Primary

Addresses

Primary practice location

2020 E 70TH St Ste 301
Shreveport, LA 71105-5332

Mailing address

2020 E 70TH St Ste 301
Shreveport, LA 71105-5332
Phone (318) 564-2493

Other practice location 1

4511 Orchid St
Shreveport, LA 71105-3131
Phone (318) 564-2493

Other practice location 2

520 Olive St
Shreveport, LA 71104-2312
Phone (318) 564-2493

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171116002649 LA Part B Supplier - Clinic/Group Practice 5395001796 Receives reassigned benefits from 5 practitioners
Practice locations: Shreveport, LA

National Provider Directory

National Provider Directory

Locations

2020 E 70th St
Ste 110
Shreveport, LA 71105
Phone (318) 553-5591

2020 E 70th St
Ste 301
Shreveport, LA 71105
Phone (318) 553-5591

Practitioners & affiliated clinicians

Practitioners 22

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1770017097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 E 70TH ST STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055332",
            "telephone_number": "318-564-2493",
            "fax_number": "318-300-3983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 E 70TH ST STE 301",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055332",
            "telephone_number": "318-564-2493",
            "fax_number": "318-300-3983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4511 Orchid St",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711053131",
            "country_code": "US",
            "telephone_number": "318-564-2493",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "520 Olive St",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711042312",
            "country_code": "US",
            "telephone_number": "318-564-2493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JACQUELYN KIRBY COUNSELING & CONSULTING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KIRBY",
        "authorized_official_first_name": "JACQUELYN",
        "authorized_official_title_or_position": "COUNSELOR/OWNER",
        "authorized_official_telephone_number": "318-564-2493",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "5034",
            "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 Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.