Active NPI
Shirley Dianne Ivie
- Mental Health Counselor
- Anchorage, AK
National Provider Identifier
1902463292
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 4000 San Ernesto Ave
Anchorage, AK 99508-2874 - Phone
- (907) 729-5020
- NPI assigned
- May 22, 2019
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
4000 San Ernesto Ave
Anchorage, AK 99508-2874
Mailing address
7033 E Tudor Rd
Anchorage, AK 99507-1262
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558483200000",
"number": "1902463292",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7033 E TUDOR RD",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995071262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4000 SAN ERNESTO AVE",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995082874",
"telephone_number": "907-729-5020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVIE",
"first_name": "SHIRLEY",
"middle_name": "DIANNE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-22",
"last_updated": "2019-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.