Individual provider Active NPI

Sandra Malone, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Metter, GA
National Provider Identifier
1073137980
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
5 SW Broad St
Metter, GA 30439-4433
Phone
(912) 515-5026
NPI assigned
Jun 5, 2020
Last updated
Jun 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X GA Primary

Addresses

Primary practice location

5 SW Broad St
Metter, GA 30439-4433

Mailing address

210 N Lewis St
Metter, GA 30439-4135
Phone (912) 314-4433

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

Practice roles

OrganizationSpecialtyStatusNew patients
Creative Counseling Solutions, LLC Addiction (Substance Use Disorder) CurrentSince Mar 19, 2023 Accepting new patients
Creative Counseling Solutions, LLC Addiction (Substance Use Disorder) PastSince Jun 7, 2020 Accepting new patients

Locations

5 SW Broad St
Metter, GA 30439
Phone (912) 507-4883

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1073137980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N LEWIS ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394135",
            "telephone_number": "912-314-4433",
            "fax_number": "912-785-2008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 SW BROAD ST",
            "city": "METTER",
            "state": "GA",
            "postal_code": "304394433",
            "telephone_number": "912-515-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONE",
        "first_name": "SANDRA",
        "credential": "CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metter, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2020; 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.