Individual provider Active NPI

Shari Gootter, MA, LPC, CRC

  • Counselor
  • Tucson, AZ
National Provider Identifier
1356851240
Registry record updated Oct 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-15964 Issued in AZ
Practice address
2450 E Speedway Blvd Ste 5
Tucson, AZ 85719-4748
Phone
(520) 603-2700
NPI assigned
Oct 4, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-15964 AZ Primary

Addresses

Primary practice location

2450 E Speedway Blvd Ste 5
Tucson, AZ 85719-4748

Mailing address

2450 E Speedway Blvd Ste 5
Tucson, AZ 85719-4748
Phone (520) 603-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LPC-15964AZMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1356851240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 E SPEEDWAY BLVD STE 5",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194748",
            "telephone_number": "520-603-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 E SPEEDWAY BLVD STE 5",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857194748",
            "telephone_number": "520-603-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOOTTER",
        "first_name": "SHARI",
        "credential": "MA, LPC, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-15964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

Verify at the official NPI Registry.