Terrie Sandstrom, LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

223 Issued in MT

Practice address

920 4TH Ave N
Great Falls, MT 59401-1514

Phone

(406) 727-8832

Fax

(406) 727-8172

NPI assigned

Jul 3, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rocky Mountain Treatment Center

  • Substance Abuse Rehabilitation Facility
  • Great Falls, MT
  • NPI 1952464448
  NPD (past)

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

{
    "created_epoch": "1341273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341273600000",
    "number": "1083978175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 4TH AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594011514",
            "telephone_number": "406-727-8832",
            "fax_number": "406-727-8172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 4TH AVE N",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594011514",
            "telephone_number": "406-727-8832",
            "fax_number": "406-727-8172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDSTROM",
        "first_name": "TERRIE",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-03",
        "last_updated": "2012-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ROCKY MOUNTAIN TREATMENT CENTER",
            "identifier": "810410694",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Addiction (Substance Use Disorder) Counselor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Addiction (Substance Use Disorder) Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2012; 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.