Shandra Pauline Spry, CO61511121

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CO61511121 Issued in WA

Practice address

825 E 5TH St
Port Angeles, WA 98362-3818

Phone

(360) 477-4790

NPI assigned

Feb 1, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• American Behavioral Health Systems, Inc.

  • Substance Abuse Rehabilitation Facility
  • Port Angeles, WA
  • NPI 1376366567
  NPD (past)

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

{
    "created_epoch": "1706745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1649033721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 E 5TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623818",
            "telephone_number": "360-477-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E 5TH ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623818",
            "telephone_number": "360-477-4790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRY",
        "first_name": "SHANDRA",
        "middle_name": "PAULINE",
        "credential": "CO61511121",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-01",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "CO61511121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Spence
• Lois J Spicer, SUDPT
• Frank H. Springob, D.C.
• Suzanne H Sproul, B.S., M.S. PA-C
• Megan Sproull, PT
• Karley Spurlock
• Bruce Ronald Spyrison, SUDPT
• SSF Bargain Warehouse LLC
• Michele Stafford, DO
• Stamper Chiropractic

• Addiction (Substance Use Disorder) Counselor in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Addiction (Substance Use Disorder) Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.