Active NPI
Gregory Austin Sanders, LAC
- Mental Health Counselor
- Laveen, AZ
National Provider Identifier
1306685490
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LAC-22722
- Practice address
- Gila River Health Center-Residential Treatment Center
3850 N. 16TH St., E. Baseline Rd.
Laveen, AZ 85339 - Phone
- (520) 796-3860
- NPI assigned
- May 20, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LAC-22722 | AZ | Primary |
Addresses
Primary practice location
Gila River Health Center-Residential Treatment Center
3850 N. 16TH St., E. Baseline Rd.
Laveen, AZ 85339
Mailing address
Gila River Health Center-Residential Treatment Center
3850 N. 16TH St., E. Baseline Rd.
Laveen, AZ 85339
Phone (520) 796-3860
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
| License | State | Type | Specialty |
|---|---|---|---|
| LAC-22722 | AZ | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1306685490",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "GILA RIVER HEALTH CENTER-RESIDENTIAL TREATMENT CENTER",
"address_2": "3850 N. 16TH ST., E. BASELINE RD.",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "85339",
"telephone_number": "520-796-3860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "GILA RIVER HEALTH CENTER-RESIDENTIAL TREATMENT CENTER",
"address_2": "3850 N. 16TH ST., E. BASELINE RD.",
"city": "LAVEEN",
"state": "AZ",
"postal_code": "85339",
"telephone_number": "520-796-3860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "GREGORY",
"middle_name": "AUSTIN",
"name_prefix": "Mr.",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-20",
"last_updated": "2024-05-20",
"certification_date": "2024-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "LAC-22722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laveen, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.