Individual provider Active NPI

Sandy Ann Marshall Humphreys, LPC LMFT

  • Professional Counselor
  • Shreveport, LA
National Provider Identifier
1891856696
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC2765 Issued in LA
Practice address
7330 Fern Ave
Suite 404
Shreveport, LA 71105-4971
Phone
(318) 797-0084
Fax
(318) 797-0844
NPI assigned
Dec 13, 2006
Last updated
Mar 11, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC2765 LA Primary
Marriage & Family Therapist 106H00000X 935 LA

Addresses

Primary practice location

7330 Fern Ave
Suite 404
Shreveport, LA 71105-4971

Mailing address

7330 Fern Ave Ste 602
Shreveport, LA 71105-4984
Phone (318) 629-0152

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

LicenseStateTypeSpecialty
LPC2765LAMDProfessional Counselor
935LAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1891856696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE STE 602",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054984",
            "telephone_number": "318-629-0152",
            "fax_number": "318-629-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 FERN AVE",
            "address_2": "SUITE 404",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711054971",
            "telephone_number": "318-797-0084",
            "fax_number": "318-797-0844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREYS",
        "first_name": "SANDY",
        "middle_name": "ANN MARSHALL",
        "name_prefix": "Mrs.",
        "credential": "LPC LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "LA",
            "license": "LPC2765",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "LA",
            "license": "935",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.