Active NPI
Kellie Marie Spear, LPCA
- Professional Counselor
- Waxhaw, NC
National Provider Identifier
1962879338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- A11754
- Practice address
- 8603 Dansington CT
Waxhaw, NC 28173-6620 - Phone
- (704) 321-9500
- NPI assigned
- Sep 1, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | A11754 | NC | Primary |
Addresses
Primary practice location
8603 Dansington CT
Waxhaw, NC 28173-6620
Mailing address
8603 Dansington CT
Waxhaw, NC 28173-6620
Phone (704) 321-9500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 19, 2024 through Jan 19, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A11754 | NC | MD | Professional Counselor |
| 11754 | NC | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441065600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441065600000",
"number": "1962879338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8603 DANSINGTON CT",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281736620",
"telephone_number": "704-321-9500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8603 DANSINGTON CT",
"city": "WAXHAW",
"state": "NC",
"postal_code": "281736620",
"telephone_number": "704-321-9500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SPEAR",
"first_name": "KELLIE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "LPCA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-01",
"last_updated": "2015-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "A11754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxhaw, NC
- Veronica Soeters
- Tara M. Soldano-Davis, M.A., LPC-A
- Soraya Montoya Soni, R.N.
- Southeast Child & Family Guidance, PLLC
- Veronica Southerland, FNP
- Alexis Ann Stadler, LCMHCA
- Maria Nicole Stephens, MARIA STEPHENS OTR/L
- Christopher George Stephenson, M.D.
- Still Souls Wellness Studios, LLC
- Christene Renae Stoke, M.A, SLP-CCC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.