Active NPI
Donnie Mack Underwood Jr., ED.S.
- Professional Counselor
- Arcadia, LA
National Provider Identifier
1942224530
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2020
- Practice address
- 1595 1St St
Arcadia, LA 71001-3515 - Phone
- (318) 263-8131
- Fax
- (318) 263-8364
- NPI assigned
- Jul 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2020 | LA | Primary |
| Marriage & Family Therapist | 106H00000X | 405 | LA |
Addresses
Primary practice location
1595 1St St
Arcadia, LA 71001-3515
Mailing address
1595 1St St
Arcadia, LA 71001-3515
Phone (318) 263-8131
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231206002315 | LA | Practitioner - Mental Health Counselor | 1355790049 | Practice locations: Arcadia, LA; Bossier City, LA |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1595 1St St
Arcadia, LA 71001-3515
Phone (318) 263-8131
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020 | LA | MD | Professional Counselor |
| 405 | LA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153958400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1432080000000",
"number": "1942224530",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1595 1ST ST",
"city": "ARCADIA",
"state": "LA",
"postal_code": "710013515",
"telephone_number": "318-263-8131",
"fax_number": "318-263-8364"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1595 1ST ST",
"city": "ARCADIA",
"state": "LA",
"postal_code": "710013515",
"telephone_number": "318-263-8131",
"fax_number": "318-263-8364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "DONNIE",
"middle_name": "MACK",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "ED.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-27",
"last_updated": "2015-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "2020",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "LA",
"license": "405",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arcadia, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.