Active NPI
Larry Joe Blue, LAC, CHW, MATS, MTH
- Addiction (Substance Use Disorder) Counselor
- Indianapolis, IN
National Provider Identifier
1851906176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 86000347A
- Practice address
- 8202 Clearvista Pkwy
Indianapolis, IN 46256-1400 - Phone
- (317) 623-3007
- Fax
- (317) 671-7189
- NPI assigned
- Sep 14, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 86000347A | IN | Primary |
Addresses
Primary practice location
8202 Clearvista Pkwy
Indianapolis, IN 46256-1400
Mailing address
8202 Clearvista Pkwy
Indianapolis, IN 46256-1400
Phone (317) 623-3007
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 32-0548053 | Other | IN | 86000347A |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Larry.Blue@sperohealth.com | Direct |
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
- Credentials
- Master of Theology
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86000347A | IN | MD | Addiction (Substance Use Disorder) Counselor |
Interoperability endpoints
- larry.blue@sperohealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1851906176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8202 CLEARVISTA PKWY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561400",
"telephone_number": "317-623-3007",
"fax_number": "317-671-7189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8202 CLEARVISTA PKWY",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462561400",
"telephone_number": "317-623-3007",
"fax_number": "317-671-7189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLUE",
"first_name": "LARRY",
"middle_name": "JOE",
"credential": "LAC, CHW, MATS, MTH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IN",
"license": "86000347A",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "86000347A",
"identifier": "32-0548053",
"state": "IN"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Larry.Blue@sperohealth.com",
"affiliation": "N",
"endpointDescription": "company email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "8202 Clearvista Pkwy",
"city": "Indianapolis",
"state": "IN",
"country_code": "US",
"postal_code": "462561400",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.