Individual provider Active NPI

Olivia Sandin

  • Clinical Social Worker
  • Cary, NC
National Provider Identifier
1003592593
Registry record updated Jul 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P019175 Issued in NC
Practice address
120 Towerview CT
Cary, NC 27513-3595
Phone
(919) 585-5085
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X P019175 NC Primary

Addresses

Primary practice location

120 Towerview CT
Cary, NC 27513-3595

Mailing address

130 Iowa LN Ste 102
Cary, NC 27511-2401

Other practice location 1

8376 Six Forks Rd Ste 104
Raleigh, NC 27615-5095
Phone (919) 585-5085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P019175NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Integrated Wellness Group, PLLC Clinical CurrentSince Jul 21, 2024 Accepting new patients

Locations

120 Towerview Ct
Cary, NC 27513
Phone (919) 585-5085

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1003592593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 IOWA LN STE 102",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275112401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 TOWERVIEW CT",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275133595",
            "telephone_number": "919-585-5085"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8376 Six Forks Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276155095",
            "country_code": "US",
            "telephone_number": "919-585-5085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDIN",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2024-07-18",
        "certification_date": "2024-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.