Active NPI
Grace McKone Shivka
- Counselor
- Chandler, AZ
National Provider Identifier
1710509609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- LPC-18192
- Practice address
- 3042 W Queen Creek Rd
Chandler, AZ 85248-2815 - Phone
- (602) 528-1200
- NPI assigned
- May 13, 2020
- Last updated
- May 13, 2020
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | LPC-18192 | AZ | Primary |
Addresses
Primary practice location
3042 W Queen Creek Rd
Chandler, AZ 85248-2815
Mailing address
PO Box 38
Sacaton, AZ 85147-0001
Phone (602) 528-1200
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-18192 | AZ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1710509609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 38",
"city": "SACATON",
"state": "AZ",
"postal_code": "851470001",
"telephone_number": "602-528-1200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3042 W QUEEN CREEK RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852482815",
"telephone_number": "602-528-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIVKA",
"first_name": "GRACE",
"middle_name": "MCKONE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "AZ",
"license": "LPC-18192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.