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Deactivated NPI 1780606145 Deactivated / Inactive NPI Female Practitioner

Sandra K Sup , MA, LPC

Counselor - Professional • Greeley, CO

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Sandra Sup has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 24, 2006
NPI Deactivation Date October 11, 2024
Total Practice Duration ~18 Years of Practice (2006 – 2024)

Professional Overview & Biography Verified Profile Summary

Sandra Sup, MA, LPC was a registered Counselor - Professional practicing in Greeley, CO. Throughout an active medical career spanning 18 years, Sandra Sup provided care at the practice location at 3211 W 20TH ST STE D until profile deactivation on 2024-10-11.

Practice Location & Contact Primary Location

Practice Address

3211 W 20th St Ste D

Greeley, CO 806346566

Telephone 9703532000
Fax 9703564827
Associated Practice Facility / Clinic
🏢 Brave Psychology, Pllc Facility NPI 1710694567

Specialty Benchmarks & Practice Insights

Comparative analytics for Counselor - Professional in Greeley, CO

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.3 Yrs
State Avg: 13.1 Yrs
Regional Practice Density
179 Specialists

Practicing in Greeley, CO (7054 Statewide)

Telehealth Adoption Rate
2.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Counselor - Professional Primary Specialty

NUCC Taxonomy Code: 101YP2500X

State License CO 638

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

9 Associated Practitioners
Dr. Jeffrey Huff , MD

Psychiatry & Neurology - Psychiatry

NPI 1033132543

Doctor of Medicine (M.D.)

Dr. Joanna Branum , MD

General Practice

NPI 1033184957

Doctor of Medicine (M.D.)

Bonnell Lindstrom , LPC

Counselor - Professional

NPI 1104146489

Licensed Professional Counselor

Mary Frantz , RN, MS, CS, CACIII

Clinical Nurse Specialist - Psychiatric/Mental Health

NPI 1104848571

Registered Nurse, Master of Science, CS, CACIII

Dr. Robert Stewart , EdD

Psychologist - Clinical

NPI 1346262706

Doctor of Education (Ed.D.)

Dr. Barry Lindstrom , PhD

Psychologist - School

NPI 1508975467

Doctor of Philosophy (Ph.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated October 11, 2024

Record deactivated on October 11, 2024

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 3211 W 20TH ST STE D, GREELEY, CO 806346566 (Tel: 9703532000)

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Updated Business Mailing Address July 08, 2007

Registered at 3211 W 20TH ST STE D, GREELEY, CO 806346566 (Tel: 9703532000)

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Provider Name / Credentials Updated July 08, 2007

Recorded as SANDRA SUP, M.A., LPC

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Counselor (License #638 in CO)

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Initial NPI Registration & Enumeration July 24, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780606145
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 24, 2006
Last Update: July 08, 2007
Deactivation Date: October 11, 2024

Mailing Address

3211 W 20th St Ste D

Greeley, CO 806346566

Phone: 9703532000

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

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