Individual provider Active NPI

Keiona Monae Thompson

  • Professional Counselor
  • Mandeville, LA
National Provider Identifier
1952816902
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
6335 Issued in LA
Practice address
900 Wilkinson St
Mandeville, LA 70448-3533
Phone
(985) 624-4450
NPI assigned
Dec 12, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 6335 LA Primary

Addresses

Primary practice location

900 Wilkinson St
Mandeville, LA 70448-3533

Mailing address

900 Wilkinson St
Mandeville, LA 70448-3533
Phone (985) 624-4450

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916000101 LA Practitioner - Mental Health Counselor 0941741136 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 Pride Dr
Suite B
Hammond, LA 70401-9527
Phone (985) 543-4730

900 Wilkinson St
Fphsa Mandeville Clinic
Mandeville, LA 70448-3533
Phone (985) 624-4450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Parishes Human Services Authority CurrentSince Jul 5, 2024 Accepting new patients
Florida Parishes Human Services Authority CurrentSince Jul 5, 2024 Accepting new patients

Locations

400 Georgia Ave
Ste 1
Bogalusa, LA 70427
Phone (985) 732-6610

1951 Florida Ave SW
Ste D
Denham Springs, LA 70726
Phone (225) 665-0473

835 Pride Dr
Ste B
Hammond, LA 70401
Phone (985) 543-4333

900 Wilkinson St
Mandeville, LA 70448
Phone (985) 624-4450

2331 Carey St
Slidell, LA 70458
Phone (985) 646-6406

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1513036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1952816902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KEIONA",
        "middle_name": "MONAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-12",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "6335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.