Active NPI
Marcy J Sprague, LPC
- Professional Counselor
- Ammon, ID
National Provider Identifier
1386986982
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-3372
- Practice address
- 3522 Briar Creek LN
Ammon, ID 83406-4728 - Phone
- (208) 529-1660
- Fax
- (208) 529-1699
- NPI assigned
- Mar 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-3372 | ID | Primary |
Addresses
Primary practice location
3522 Briar Creek LN
Ammon, ID 83406-4728
Mailing address
3522 Briar Creek LN
PO Box 3858
Ammon, ID 83406-4728
Phone (208) 529-1660
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-3372 | Other | ID | STATE LICENSE - LPC |
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 |
|---|---|---|---|
| LPC-3372 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363824000000",
"number": "1386986982",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3522 BRIAR CREEK LN",
"address_2": "PO BOX 3858",
"city": "AMMON",
"state": "ID",
"postal_code": "834064728",
"telephone_number": "208-529-1660",
"fax_number": "208-529-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3522 BRIAR CREEK LN",
"city": "AMMON",
"state": "ID",
"postal_code": "834064728",
"telephone_number": "208-529-1660",
"fax_number": "208-529-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPRAGUE",
"first_name": "MARCY",
"middle_name": "J",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-03-21",
"last_updated": "2013-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-3372",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE - LPC",
"identifier": "LPC-3372",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ammon, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.