Active NPI
Kellye Jean Lewis, MA, LPC, NCC
- Professional Counselor
- Shreveport, LA
National Provider Identifier
1952815458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC6093
- Practice address
- 3821 Southern Ave
Shreveport, LA 71106-1033 - Phone
- (318) 946-8157
- NPI assigned
- Nov 21, 2017
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC6093 | LA | Primary |
Addresses
Primary practice location
3821 Southern Ave
Shreveport, LA 71106-1033
Mailing address
108 Colin P Kelly Dr
Minden, LA 71055-7912
Phone (318) 402-6379
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC6093 | LA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Recovery LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Addiction (Substance Use Disorder) Counselor
- Shreveport, LA
- NPI 1285998716
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1511222400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511222400000",
"number": "1952815458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "108 COLIN P KELLY DR",
"city": "MINDEN",
"state": "LA",
"postal_code": "710557912",
"telephone_number": "318-402-6379"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3821 SOUTHERN AVE",
"city": "SHREVEPORT",
"state": "LA",
"postal_code": "711061033",
"telephone_number": "318-946-8157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "KELLYE",
"middle_name": "JEAN",
"credential": "MA, LPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-21",
"last_updated": "2017-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "LA",
"license": "LPC6093",
"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 Nov 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.