Individual provider Active NPI

Sandra E Moran, MS, LMHC

  • Mental Health Counselor
  • Griffith, IN
National Provider Identifier
1174830582
Registry record updated May 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39002112A Issued in IN
Practice address
1307 N Arbogast St
Griffith, IN 46319-1844
Phone
(219) 680-9743
Fax
(219) 923-3060
NPI assigned
Sep 7, 2010
Last updated
May 17, 2013By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39002112A IN Primary

Addresses

Primary practice location

1307 N Arbogast St
Griffith, IN 46319-1844

Mailing address

1307 N Arbogast St
Griffith, IN 46319-1844
Phone (219) 680-9743

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
39002112AINMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1174830582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1307 N ARBOGAST ST",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463191844",
            "telephone_number": "219-680-9743",
            "fax_number": "219-923-3060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1307 N ARBOGAST ST",
            "city": "GRIFFITH",
            "state": "IN",
            "postal_code": "463191844",
            "telephone_number": "219-680-9743",
            "fax_number": "219-923-3060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "SANDRA",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MS, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39002112A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Griffith, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.