Active NPI
Tina Wilma Sanborn, MSMFT
- Marriage & Family Therapist
- Liberty, MO
National Provider Identifier
1093157133
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 2011012317
- Practice address
- 1170 W. Kansas St.
Liberty, MO 64068 - Phone
- (816) 351-7834
- NPI assigned
- Jul 17, 2013
- Last updated
- Jul 17, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 2011012317 | MO | Primary |
Addresses
Primary practice location
1170 W. Kansas St.
Liberty, MO 64068
Mailing address
1806 Mansfield Rd
Saint Joseph, MO 64504
Phone (816) 351-7834
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 10, 2024 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011012317 | MO | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1374019200000",
"number": "1093157133",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1806 MANSFIELD RD",
"city": "SAINT JOSEPH",
"state": "MO",
"postal_code": "64504",
"telephone_number": "816-351-7834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1170 W. KANSAS ST.",
"city": "LIBERTY",
"state": "MO",
"postal_code": "64068",
"telephone_number": "816-351-7834"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANBORN",
"first_name": "TINA",
"middle_name": "WILMA",
"credential": "MSMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-07-17",
"last_updated": "2013-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "MO",
"license": "2011012317",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Liberty, MO
- Kevin D Sadler
- Sonica Saini
- Saint Lukes Radiation Therapy-Liberty LLC
- Noor Salam
- Samuel U. Rodgers Health Center, Inc. (Samuel U. Rodgers Health Center Clay County Family Medicine & Dental)
- Selina Sanchez, PSY.D.
- Allison Santen, LCSW
- Laurel Saplys
- Sarah Ehlers, LCSW LLC
- Katherine E Saverino-Jorgensen, M.S., CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.