Sandra Gene Gavin, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

178.014115 Issued in IL

Practice address

1313 Sarah LN
Alamosa, CO 81101-2262

Phone

(563) 605-3971

NPI assigned

Oct 20, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  CO, Mental Health

  Medicare reassignment NPD
• Lighthouse Professional Counseling Center, LLC

  • Community/Behavioral Health Agency
  • Sycamore, IL
  • NPI 1659720332
  NPD (past)
• Passion for Living Counseling Services LLC

  • Community/Behavioral Health Agency
  • Sycamore, IL
  • NPI 1457869679
  NPD (past)

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

{
    "created_epoch": "1539993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1467928192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1474 LEGACY DR UNIT 4",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152079",
            "telephone_number": "563-605-3971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 SARAH LN",
            "city": "ALAMOSA",
            "state": "CO",
            "postal_code": "811012262",
            "telephone_number": "563-605-3971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "SANDRA",
        "middle_name": "GENE",
        "name_prefix": "Dr.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-20",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0018170",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "178.014115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Garcia
• Kelly J Gardea
• Mallori Linn Gariner, FNP
• Herbert Garrard
• Jacqueline M Garrard, M.D.
• Jonathan Robert Gears, LPC
• David N. Geiger, D.O.
• Susan M. Geiger, D.O.
• Genoa Healthcare LLC
• Kelly George

• All providers in Alamosa, CO
• Professional Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.