Individual provider Active NPI

Jose Sandoval, MSSW, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • McAllen, TX
National Provider Identifier
1164895710
Registry record updated Feb 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12499 Issued in TX
Practice address
701 N Ware Rd
McAllen, TX 78501-6616
Phone
(956) 664-0057
Fax
(956) 664-2846
NPI assigned
Nov 4, 2015
Last updated
Feb 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12499 TX Primary

Addresses

Primary practice location

701 N Ware Rd
McAllen, TX 78501-6616

Mailing address

701 N Ware Rd
McAllen, TX 78501-6616
Phone (956) 664-0057

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

LicenseStateTypeSpecialty
12499TXMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Challenges and Change PLLC Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582416000000",
    "number": "1164895710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 N WARE RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016616",
            "telephone_number": "956-664-0057",
            "fax_number": "956-664-2846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 N WARE RD",
            "city": "MCALLEN",
            "state": "TX",
            "postal_code": "785016616",
            "telephone_number": "956-664-0057",
            "fax_number": "956-664-2846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "JOSE",
        "credential": "MSSW, LCDC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-04",
        "last_updated": "2020-02-23",
        "certification_date": "2020-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McAllen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2020; 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.