1235233933 NPI number — HARRY LEE SPURLING MA LMFT LPCMHSP LSPE

Table of content: (NPI 1295125110)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235233933 NPI number — HARRY LEE SPURLING MA LMFT LPCMHSP LSPE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPURLING
Provider First Name:
HARRY
Provider Middle Name:
LEE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA LMFT LPCMHSP LSPE
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1235233933
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/11/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1167 SPRATLIN PARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRAY
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37615-6205
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
423-467-3600
Provider Business Mailing Address Fax Number:
423-467-3644

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 W WATAUGA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JOHNSON CITY
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37604
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
423-232-2700
Provider Business Practice Location Address Fax Number:
423-232-2714
Provider Enumeration Date:
09/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  LSPE137 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 106H00000X , with the licence number: LMFT163 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 420 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12900 . This is a "UBH HEALTHPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12900 . This is a "UBH JOHN DEERE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3070480 . This is a "MAGELLAN NAVIGATOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "INITIAL GROUP GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010149428 . This is a "VIRGINIA MEDICAID CTC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1047963 . This is a "CIGNA MCC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 250190 . This is a "ANTHEM PROF TRIGON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 334969 . This is a "VALUEOPTIONS GROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "CARITEN PHP HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3070480 . This is a "MAGELLAN SUMMIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010149339 . This is a "VIRGINIA MEDICAID WATAUGA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12900 . This is a "UBH SENIOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "CARITEN PHP POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12900 . This is a "UBH EMPLOYER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "CARITEN PHP PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 250190 . This is a "ANTHEM PREF TRIGON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "CARITEN PHP WORKCO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 620582605 . This is a "BEECH STREET" identifier . This identifiers is of the category "OTHER".




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