SANDRA K SUP (NPI# 1780606145) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780606145 |
| Entity Type | Individual |
| Full Name | SANDRA K SUP |
| Credential | M.A., LPC |
| Practice Address |
3211 W 20th St Ste D Greeley CO 80634-6566 |
| Practice Telephone | 9703532000 |
| Practice Fax Number | 9703564827 |
| Mailing Telephone | 9703532000 |
| Mailing Fax Number | 9703564827 |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
638 | CO | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | BLUE CROSS PROVIDER NO | 643342 | 01 |
| CO | VALUE OPTIONS PROVIDER NO | 057772 | 01 |
| Street Address |
3211 W 20TH ST STE D |
| City | GREELEY |
| State | CO |
| Zip Code | 80634-6566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508484296 | Hilary Christine Abbath | Massage Therapist | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2020-07-08 |
| 1104146489 | Bonnell K Lindstrom | Counselor | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2010-06-09 |
| 1972512010 | Antoinette Joyce Pasquale | Counselor | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2006-08-07 |
| 1033132543 | Jeffrey B Huff | Psychiatry & Neurology | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2006-07-25 |
| 1831112341 | Russell Adam Johnson | Psychiatry & Neurology | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2006-07-25 |
| 1104848571 | Mary Catherine Frantz | Clinical Nurse Specialist | 3211 W 20th St Ste D, Greeley, CO 80634-6566 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831707843 | Witting Medical, LLC | Pathology | 17 Dos Rios, Greeley, CO 80634 | 2020-07-15 |
| 1730706102 | Heart Centered Counseling | Counselor | 1770 W 25th Street #206, Greeley, CO 80634 | 2020-07-01 |
| 1396374237 | Kidstuff Child and Family Counseling, P.C. | Counselor | 1770 25th Ave., Ste. 102, Greeley, CO 80634 | 2020-04-03 |
| 1164055745 | Stephanie Alexis Balunda | Speech-Language Pathologist | Uchealth Physical Therapy and Rehabilitation Clinic, 6767 West 29th St., Greeley, CO 80634 | 2020-02-21 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1043797749 | Burt Stewart Dmd Pllc | Clinic/Center | 6937 West 10th Street, Greeley, CO 80634 | 2018-07-25 |
| 1164913885 | Innovations Pediatric Therapy, LLC | Occupational Therapist | 3403 W 7th St Apt A, Greeley, CO 80634 | 2018-05-29 |
| 1003305319 | Austin Michael Lake | Physical Therapist | 4681 W 20th St Unit 202b, Greeley, CO 80634 | 2018-05-02 |
| 1225542004 | Kevin Lichner | Specialist/Technologist | 522 28th Ave, Greeley, CO 80634 | 2017-11-30 |
| 1538683909 | Stacie Jackson | Physician Assistant | 6500 West 29th St Ste 106, Greeley, CO 80634 | 2017-07-27 |
| Find all providers in zip 80634 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760043897 | Neurofeedback Clinic of Northern Colorado LLC | Counselor | 8203 W 20th St, Greeley, CO 80634-4696 | 2019-06-28 |
| 1407413727 | Stephen P Street Pllc | Counselor | 4657 W. 20th Street, Unit B, Greeley, CO 80634 | 2019-05-22 |
| 1225529985 | Jeff Bailey | Counselor | 800 8th Ave Ste 233, Greeley, CO 80631-1187 | 2018-05-29 |
| 1255829834 | Maya Schmidt | Counselor | 2510 15th Ave, Greeley, CO 80631-8327 | 2018-04-29 |
| 1447766647 | Patricia G Ferguson | Counselor | 14272 Wcr 72, Greeley, CO 80631 | 2017-12-26 |
| 1942721121 | Patricia L Dunlap | Counselor | 1015 37th Ave Court, Suite 102, Greeley, CO 80634-8063 | 2017-06-28 |
| 1811425648 | Vilma Cardona | Counselor | 1013 9th Ave Ste 2, Greeley, CO 80631-4013 | 2017-05-24 |
| 1871028522 | Melody Huskerson | Counselor | 8213 W 20th St, Greeley, CO 80634-3031 | 2017-05-01 |
| 1205283298 | Richard J Steele | Counselor | 3835 W 10th St, Suite 100j, Greeley, CO 80634-1500 | 2016-05-19 |
| 1689058430 | Mindwise | Counselor | 918 13th St, #5, Greeley, CO 80631-4667 | 2015-07-10 |
| Find all providers in GREELEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.