Marvin Mathias Sandifer, MSW, LCSW, LCAS

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C007317 Issued in NC

Practice address

810 Warren St
Greensboro, NC 27403-2340

Phone

(336) 517-3770

Fax

(336) 517-3783

NPI assigned

Nov 18, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1384732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1194155887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13890",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274153890",
            "telephone_number": "336-621-3381",
            "fax_number": "336-621-7513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 WARREN ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274032340",
            "telephone_number": "336-517-3770",
            "fax_number": "336-517-3783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIFER",
        "first_name": "MARVIN",
        "middle_name": "MATHIAS",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW, LCAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-18",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara McNeill Sanders, RN
• Shevon Sanders
• Stephen Brian Sanders, M.D.
• Stephen Sanderson, PT
• Mahesh S. Sandhu, DO
• Jennifer Sandoval Bejarano
• Sandra L Fuller DDS PA
• Sandra L. Fuller,DDS,P.a.
• Brenda K Sandridge, PA
• Christie Sanford, DDS

• Clinical Social Worker in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.