Kristin Sandusky

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

21496 Issued in FL

Practice address

5131 Manatee Ave W
Bradenton, FL 34209-3740

Phone

(941) 792-0802

NPI assigned

Nov 16, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Bradenton Counseling Center IncGroup PAC ID 7012199565, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bradenton Counseling Center, Inc.

  • Mental Health Counselor
  • Bradenton, FL
  • NPI 1639472939
  Medicare reassignment Care Compare group NPD
• West Bradenton Therapy Services Inc

  • Community/Behavioral Health Agency
  • Bradenton, FL
  • NPI 1649100389
  NPD Authorized official

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668556800000",
    "number": "1083323208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1208 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094154",
            "telephone_number": "941-518-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5131 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342093740",
            "telephone_number": "941-792-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDUSKY",
        "first_name": "KRISTIN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "21496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bcc@counselingsecure.com",
            "affiliation": "N",
            "endpointDescription": "e-mail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5131 Manatee Ave W",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342093740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lajuan Sanchez, ARNP, CNM
• Luisa Yesenia Sanchez, PT
• Kimberly A Sand, ARNP
• Teresa Sanders
• Leah Denise Sandridge, LCSW
• Kelly Travers Sansone, MSW, LSW
• Alvin Rafael Santa-Ana
• Nicole Mari Santana Rodriguez, DC
• Diana Beatriz Santiago Alvarado
• Jonas Justin Tizon Santos, DO

• Mental Health Counselor in Bradenton, FL
• Providers in Bradenton, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.