Individual provider Active NPI

Sandra Ruth Sanford, MSW

  • Clinical Social Worker
  • Broken Arrow, OK
National Provider Identifier
1104987080
Registry record updated Oct 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3890 Issued in OK
Practice address
840 S Aspen Ave
Ste E
Broken Arrow, OK 74012-4803
Phone
(918) 814-4451
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3890 OK Primary

Addresses

Primary practice location

840 S Aspen Ave
Ste E
Broken Arrow, OK 74012-4803

Mailing address

209 W Broadway St
Okemah, OK 74859-2618
Phone (918) 623-2922

Other names 1

  • Mrs. Sandra R Rowe Former name

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Behavioral Healthcare Past Accepting new patients
Holistic Counseling, PLLC Past Accepting new patients
Southeastern Behavioral Healthcare PastSince Dec 18, 2013 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634774400000",
    "number": "1104987080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 W BROADWAY ST",
            "city": "OKEMAH",
            "state": "OK",
            "postal_code": "748592618",
            "telephone_number": "918-623-2922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 S ASPEN AVE",
            "address_2": "STE E",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740124803",
            "telephone_number": "918-814-4451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "SANDRA",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-10-21",
        "certification_date": "2021-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OK",
            "license": "3890",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SANDRA",
            "last_name": "ROWE",
            "middle_name": "R",
            "prefix": "MRS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broken Arrow, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2021; 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.