Active NPI
Keishay Izzard, E.D
- Marriage & Family Therapist
- Houston, TX
National Provider Identifier
1851701809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 5682948
- Practice address
- 12955 Willow Place Dr W
Houston, TX 77070-5651 - Phone
- (209) 354-6234
- NPI assigned
- Apr 29, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 10
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 5682948 | CA | Primary |
| Behavior Analyst | 103K00000X | |||
| Art Therapist | 221700000X | |||
| Dance Therapist | 225600000X | |||
| Developmental Therapist | 222Q00000X | |||
| Massage Therapist | 225700000X | |||
| Music Therapist | 225A00000X | |||
| Mental Health Counselor | 101YM0800X | |||
| Child Mental Illness Respite Care | 385HR2055X | |||
| Private Vehicle | 347C00000X |
Addresses
Primary practice location
12955 Willow Place Dr W
Houston, TX 77070-5651
Mailing address
12955 Willow Place Dr W
Houston, TX 77070-5651
Phone (209) 354-6234
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5682948 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407110400000",
"number": "1851701809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12955 WILLOW PLACE DR W",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770705651",
"telephone_number": "209-354-6234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12955 WILLOW PLACE DR W",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770705651",
"telephone_number": "209-354-6234"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZZARD",
"first_name": "KEISHAY",
"credential": "E.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-04-29",
"last_updated": "2014-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "5682948",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "221700000X",
"taxonomy_group": "",
"desc": "Art Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225600000X",
"taxonomy_group": "",
"desc": "Dance Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "222Q00000X",
"taxonomy_group": "",
"desc": "Developmental Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225A00000X",
"taxonomy_group": "",
"desc": "Music Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "385HR2055X",
"taxonomy_group": "",
"desc": "Respite Care, Respite Care, Mental Illness, Child",
"state": null,
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.