Mandy Kay Sproul, MAAT, LPC, ATR
Individual provider Active NPI Professional Counselor · Madrid, NM
NPI 1194474700 · NPPES record last updated Feb 23, 2024
Key facts
- NPI
- 1194474700
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- LPC.00181015 (CO)
- Practice address
- 1 Backroad
Madrid, NM 87010-9727 - Phone
- (515) 996-0278
- NPI assigned
- Mar 21, 2022
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1 Backroad
Madrid, NM 87010-9727
Phone (515) 996-0278
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240905001956 | NM | Practitioner - Mental Health Counselor | 6305386343 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC.00181015 | CO | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sprouting Minds Art Therapy LLC | Current |
Accepting new patients | |
| Bluejay Counseling | Current |
Accepting new patients | |
| Kidstuff Child and Family Counseling, P.C. | Professional | Past | Accepting new patients |
| Kidstuff Child & Family Counseling, P.C. | Past | Accepting new patients | |
| Kidstuff Child and Family Counseling, P.C. | Professional | Past | Accepting new patients |
| Kidstuff Child and Family Counseling, P.C. | Professional | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC.00181015 | CO | Yes |
Addresses
Primary practice location
1 Backroad
Madrid, NM 87010-9727
Mailing address
1 Backroad
Madrid, NM 87010-9727
Phone (515) 996-0278
Other practice location 1
555 S Camino Del Rio Ste C1-B
Durango, CO 81303-6826
Phone (970) 775-7061
Other providers in Madrid, NM
All providers in Madrid, NM · Professional Counselor in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.