Mariana Sandoval

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Phoenix, OR

NPI 1194183111 · NPPES record last updated Feb 4, 2016

Key facts

NPI
1194183111
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
Practice address
149 S Main St
Phoenix, OR 97535-6631
Phone
(541) 535-4133
NPI assigned
Feb 4, 2016
Sex
Female
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Counseling Center, Inc. Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.qualifacts.org/api/fhir/phoenixcounseling/r4/

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Yes

Addresses

Primary practice location

149 S Main St
Phoenix, OR 97535-6631

Mailing address

2644 Carr St
White City, OR 97503-1104

Other providers in Phoenix, OR

All providers in Phoenix, OR · Addiction (Substance Use Disorder) Counselor in Oregon

Sources for this page

Verify at the official NPI Registry.