Active NPI
Edwin Stephan Sandor, LPC, LICDC
- Professional Counselor
- Columbus, OH
National Provider Identifier
1124269519
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- CO880109
- Practice address
- 1555 Bethel Rd
Columbus, OH 43220-2003 - Phone
- (614) 442-0664
- Fax
- (614) 442-0620
- NPI assigned
- Mar 13, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 98119 | OH | |
| Professional Counselor | 101YP2500X | CO880109 | OH | Primary |
Addresses
Primary practice location
1555 Bethel Rd
Columbus, OH 43220-2003
Mailing address
1555 Bethel Rd
Columbus, OH 43220-2003
Phone (614) 442-0664
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 98119 | OH | MD | Addiction (Substance Use Disorder) Counselor |
| CO880109 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236902400000",
"number": "1124269519",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1555 BETHEL RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432202003",
"telephone_number": "614-442-0664",
"fax_number": "614-442-0620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1555 BETHEL RD",
"city": "COLUMBUS",
"state": "OH",
"postal_code": "432202003",
"telephone_number": "614-442-0664",
"fax_number": "614-442-0620"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDOR",
"first_name": "EDWIN",
"middle_name": "STEPHAN",
"credential": "LPC, LICDC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-03-13",
"last_updated": "2009-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "OH",
"license": "98119",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "CO880109",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.