Provider Demographics
NPI:1871605345
Name:SPURRY, KATHERINE (LAC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:SPURRY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14907 GLENSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96161-1344
Mailing Address - Country:US
Mailing Address - Phone:928-607-3501
Mailing Address - Fax:
Practice Address - Street 1:14907 GLENSHIRE DR
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-1344
Practice Address - Country:US
Practice Address - Phone:928-607-3501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2025-11-13
Deactivation Date:2025-10-22
Deactivation Code:
Reactivation Date:2025-11-13
Provider Licenses
StateLicense IDTaxonomies
AZLAC-12228101Y00000X
CA36246103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical