Individual provider Active NPI

Spenser G Sawyers, LPCC

  • Professional Counselor
  • Bowling Green, KY
National Provider Identifier
1336685262
Registry record updated Aug 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
265305 Issued in KY
Practice address
4980 Mount Olivet Rd
Bowling Green, KY 42101-9668
Phone
(615) 348-7855
NPI assigned
Jan 17, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X
Professional Counselor 101YP2500X 265305 KY Primary

Addresses

Primary practice location

4980 Mount Olivet Rd
Bowling Green, KY 42101-9668

Mailing address

121 E Due West Ave
Madison, TN 37115-5201
Phone (270) 991-5923

Other identifiers 1

IdentifierTypeStateIssuer
7100736040MedicaidKY

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
265305KYMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifeskills, Inc. PastSince Aug 27, 2015 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1336685262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 E DUE WEST AVE",
            "city": "MADISON",
            "state": "TN",
            "postal_code": "371155201",
            "telephone_number": "270-991-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4980 MOUNT OLIVET RD",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421019668",
            "telephone_number": "615-348-7855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAWYERS",
        "first_name": "SPENSER",
        "middle_name": "G",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-01-17",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "265305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100736040",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.