Sandra Pumphrey, M.S.W.

Individual provider Active NPI Clinical Social Worker · Sault Sainte Marie, MI

NPI 1104914290 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104914290
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
SP046184 (MI)
Practice address
3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286
Phone
(906) 632-2805
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 4

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
SP046184MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Weber and Devers Psychological Services, P.C. Clinical Past
since May 19, 2018
Accepting new patients
Hiawatha Community Mental Health Authority Past Accepting new patients
Hiawatha Community Mental Health Authority Past Accepting new patients
Hiawatha Community Behavioral Health Authority Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SP046184 MI Yes

Addresses

Primary practice location

3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286

Mailing address

3865 S Mackinac TRL
Sault Sainte Marie, MI 49783-9286

Other identifiers

IdentifierTypeStateIssuer
7509104110OtherMIBCBS

Other providers in Sault Sainte Marie, MI

All providers in Sault Sainte Marie, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.