Kenneth Elgin Beatty

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

864 Olive St
Shreveport, LA 71104-2159

Phone

(318) 222-0759

Fax

(318) 221-0216

NPI assigned

Feb 15, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Center for Families, Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Shreveport, LA
  • NPI 1922150689
  NPD (past)

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1902179336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 DILLINGHAM AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711063303",
            "telephone_number": "318-865-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "864 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042159",
            "telephone_number": "318-222-0759",
            "fax_number": "318-221-0216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEATTY",
        "first_name": "KENNETH",
        "middle_name": "ELGIN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Mitchell Beal
• Michael J. Beal, MD
• Calvin Beaner Sr.
• Patrice A Beaner
• Carrie L. Bearden, MD
• Dominique J. Beaudry, MD
• Kathryn Elizabeth Beauregard-Southerland, D.D.S.
• Beautifli, LLC.
• David Lee Beaver, MD
• Kelly Louise Beavers, APRN, FNP-C

• Mental Health Counselor in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Mental Health Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.