Individual provider Active NPI

Sherri Dawn Helterbran, LPC

  • Counselor
  • Queen Creek, AZ
National Provider Identifier
1770059644
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
LPC-16994 Issued in AZ
Practice address
22511 S 202ND St
Queen Creek, AZ 85142-6259
Phone
(480) 712-6586
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X LPC-16994 AZ Primary

Addresses

Primary practice location

22511 S 202ND St
Queen Creek, AZ 85142-6259

Mailing address

22511 S 202ND St
Queen Creek, AZ 85142-6259
Phone (480) 712-6586

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 8, 2024 through Jan 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC-16994AZMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
New Legacy Counseling, Az, PLLC PastSince Mar 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1539820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1770059644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22511 S 202ND ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426259",
            "telephone_number": "480-712-6586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22511 S 202ND ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851426259",
            "telephone_number": "480-712-6586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELTERBRAN",
        "first_name": "SHERRI",
        "middle_name": "DAWN",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-18",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "AZ",
            "license": "LPC-16994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queen Creek, AZ

Sources for this page

Verify at the official NPI Registry.