Individual provider Active NPI

Kasandra Carol Anspach-Sportsman, MSW, LCSW

  • Clinical Social Worker
  • Fayetteville, NC
National Provider Identifier
1083703318
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C00567 Issued in NC
Practice address
901 Arsenal Ave Ste 201
Fayetteville, NC 28305-5478
Phone
(910) 323-3368
Fax
(910) 486-7000
NPI assigned
Oct 12, 2006
Last updated
May 2, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X COO5657
Clinical Social Worker 1041C0700X P002867 NC
Clinical Social Worker 1041C0700X C00567 NC Primary

Addresses

Primary practice location

901 Arsenal Ave Ste 201
Fayetteville, NC 28305-5478

Mailing address

114 Shadsford Blvd
Fayetteville, NC 28314-1221
Phone (910) 867-9495

Other practice location 1

901 Arsenal Ave Ste 202
Fayetteville, NC 28305-5478
Phone (910) 323-3368

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20121029000109 NC Practitioner - Clinical Social Worker 3870743826 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Biblical Counseling ServicesGroup PAC ID 7315183407, 6 clinicians

Practice addresses (Care Compare)

901 Arsenal Ave
Suite 202
Fayetteville, NC 28305-5478
Phone (910) 323-3368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C00567NCMDClinical Social Worker
P002867NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Biblical Counseling Services CurrentSince Apr 15, 2022 Accepting new patients
Integrated Behavioral Healthcare Services, PA Social Worker CurrentSince May 1, 2019 Accepting new patients

Locations

2577 Ravenhill Dr
Fayetteville, NC 28303
Phone (910) 438-0947

901 Arsenal Ave
Ste 201
Fayetteville, NC 28305
Phone (910) 323-3368

901 Arsenal Ave
Ste 202
Fayetteville, NC 28305
Phone (910) 323-3368

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1083703318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 SHADSFORD BLVD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283141221",
            "telephone_number": "910-867-9495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 ARSENAL AVE STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055478",
            "telephone_number": "910-323-3368",
            "fax_number": "910-486-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "901 Arsenal Ave Ste 202",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283055478",
            "country_code": "US",
            "telephone_number": "910-323-3368",
            "fax_number": "910-486-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANSPACH-SPORTSMAN",
        "first_name": "KASANDRA",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": "COO5657",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P002867",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C00567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.