Individual provider Active NPI

Sandra Lee John, LPC

  • Professional Counselor
  • Lakeville, PA
National Provider Identifier
1962493973
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
PC003464 Issued in PA
Practice address
1258 Purdytown Tpke
Route 590 East
Lakeville, PA 18438-6793
Phone
(570) 226-1963
Fax
(570) 226-1967
NPI assigned
Oct 31, 2005
Last updated
Mar 27, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X PC003464 PA Primary

Addresses

Primary practice location

1258 Purdytown Tpke
Route 590 East
Lakeville, PA 18438-6793

Mailing address

451 S Hanover St
Nanticoke, PA 18634-2701
Phone (570) 735-3474

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
PC003464PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1962493973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 S HANOVER ST",
            "city": "NANTICOKE",
            "state": "PA",
            "postal_code": "186342701",
            "telephone_number": "570-735-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1258 PURDYTOWN TPKE",
            "address_2": "ROUTE 590 EAST",
            "city": "LAKEVILLE",
            "state": "PA",
            "postal_code": "184386793",
            "telephone_number": "570-226-1963",
            "fax_number": "570-226-1967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "SANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-31",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC003464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2009; 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.