Individual provider Active NPI

Sean M Makepeace, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Spearfish, SD
National Provider Identifier
1124530415
Registry record updated Oct 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
08041354 Issued in SD
Practice address
710 E Colorado Blvd
Spearfish, SD 57783-4701
Phone
(605) 642-7093
Fax
(605) 722-3931
NPI assigned
Oct 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 08041354 SD Primary

Addresses

Primary practice location

710 E Colorado Blvd
Spearfish, SD 57783-4701

Mailing address

710 E Colorado Blvd
Spearfish, SD 57783-4701
Phone (605) 642-7093

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
08041354SDMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508976000000",
    "number": "1124530415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 E COLORADO BLVD",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577834701",
            "telephone_number": "605-642-7093",
            "fax_number": "605-722-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 E COLORADO BLVD",
            "city": "SPEARFISH",
            "state": "SD",
            "postal_code": "577834701",
            "telephone_number": "605-642-7093",
            "fax_number": "605-722-3931"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAKEPEACE",
        "first_name": "SEAN",
        "middle_name": "M",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2017-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "SD",
            "license": "08041354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spearfish, SD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.

Verify at the official NPI Registry.