Individual provider Active NPI

Sharon Lee Lietar

  • Child Mental Illness Respite Care
  • Safford, AZ
National Provider Identifier
1013192335
Registry record updated Jan 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child Mental Illness Respite CareTaxonomy code 385HR2055X
License
511497 Issued in AZ
Practice address
5810 S US Highway 191
Safford, AZ 85546-9559
Phone
(928) 348-8891
NPI assigned
Jan 5, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child Mental Illness Respite Care 385HR2055X 511497 AZ Primary

Addresses

Primary practice location

5810 S US Highway 191
Safford, AZ 85546-9559

Mailing address

5810 S US Highway 191
Safford, AZ 85546-9559
Phone (928) 348-8891

Other identifiers 1

IdentifierTypeStateIssuer
511497OtherAZLICENSE

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
511497AZMDChild Mental Illness Respite Care

NPI Registry JSON

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

{
    "created_epoch": "1199491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199491200000",
    "number": "1013192335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5810 S US HIGHWAY 191",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855469559",
            "telephone_number": "928-348-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5810 S US HIGHWAY 191",
            "city": "SAFFORD",
            "state": "AZ",
            "postal_code": "855469559",
            "telephone_number": "928-348-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIETAR",
        "first_name": "SHARON",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-05",
        "last_updated": "2008-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "AZ",
            "license": "511497",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "511497",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Safford, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2008; 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.