Individual provider Active NPI

Samuel Brossard McCune, LPC

  • Counselor
  • Sheridan, WY
National Provider Identifier
1437689668
Registry record updated Mar 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
PPC-1007 Issued in WY
Practice address
1949 Sugarland Dr Ste 221
Sheridan, WY 82801-5766
Phone
(307) 763-8121
Fax
(307) 673-5167
NPI assigned
Jun 20, 2017
Last updated
Mar 31, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X PPC-1007 WY Primary

Addresses

Primary practice location

1949 Sugarland Dr Ste 221
Sheridan, WY 82801-5766

Mailing address

1949 Sugarland Dr Ste 221
Sheridan, WY 82801-5766
Phone (307) 763-8121

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
PPC-1007WYMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1497916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648684800000",
    "number": "1437689668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 SUGARLAND DR STE 221",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015766",
            "telephone_number": "307-763-8121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 SUGARLAND DR STE 221",
            "city": "SHERIDAN",
            "state": "WY",
            "postal_code": "828015766",
            "telephone_number": "307-763-8121",
            "fax_number": "307-673-5167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUNE",
        "first_name": "SAMUEL",
        "middle_name": "BROSSARD",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-20",
        "last_updated": "2022-03-31",
        "certification_date": "2022-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WY",
            "license": "PPC-1007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheridan, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.