Individual provider Active NPI

Bruce A Louis

  • Mental Health Counselor
  • Chesterfield, VA
National Provider Identifier
1972114759
Registry record updated Jan 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
60809541 Issued in WA
Practice address
15607 Chesdin Manor Dr
Chesterfield, VA 23838-4520
Phone
(360) 485-6212
Fax
(804) 451-9078
NPI assigned
Aug 13, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 60809541 WA Primary

Addresses

Primary practice location

15607 Chesdin Manor Dr
Chesterfield, VA 23838-4520

Mailing address

PO Box 1704
Chesterfield, VA 23832-9107
Phone (360) 485-6212

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

LicenseStateTypeSpecialty
60809541WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Move in Faith Counseling Services, PLLC Counselor CurrentSince Aug 1, 2020 Accepting new patients
Key Counseling PLLC Mental Health PastSince Jul 28, 2024 Accepting new patients

Locations

719 Sleater Kinney Rd SE
Ste 212
Olympia, WA 98503
Phone (360) 509-0724

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": "1597276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642723200000",
    "number": "1972114759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1704",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238329107",
            "telephone_number": "360-485-6212",
            "fax_number": "804-451-9078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15607 CHESDIN MANOR DR",
            "city": "CHESTERFIELD",
            "state": "VA",
            "postal_code": "238384520",
            "telephone_number": "360-485-6212",
            "fax_number": "804-451-9078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUIS",
        "first_name": "BRUCE",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-13",
        "last_updated": "2022-01-21",
        "certification_date": "2022-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "60809541",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.