Sara Jean Spivey, MS, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LAC-16245 Issued in AZ

Practice address

13460 N 94TH Dr Ste M1
Peoria, AZ 85381-4247

Phone

(623) 974-3333

NPI assigned

Nov 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1604620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1326649153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE M1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814247",
            "telephone_number": "623-974-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 N 94TH DR STE M1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814247",
            "telephone_number": "623-974-3333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3519 E Shea Blvd Ste 138",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850283349",
            "country_code": "US",
            "telephone_number": "480-258-3595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPIVEY",
        "first_name": "SARA",
        "middle_name": "JEAN",
        "credential": "MS, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-06",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AZ",
            "license": "LAC-16245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Mental Health Counselor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.