Emil William Sandstrom, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0904009870 Issued in VA

Practice address

6999 Carrrolton Pike
Galax, VA 24333

Phone

(276) 238-5600

NPI assigned

May 22, 2017

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 VA

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

Specialty

Clinical Social Worker

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mount Rogers Community ServicesGroup PAC ID 1254387475, 33 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Mount Rogers Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wytheville, VA
  • NPI 1255365599
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1215464292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 W RIDGE RD",
            "city": "WYTHEVILLE",
            "state": "VA",
            "postal_code": "243821187",
            "telephone_number": "276-223-3200",
            "fax_number": "276-223-0617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6999 CARRROLTON PIKE",
            "city": "GALAX",
            "state": "VA",
            "postal_code": "24333",
            "telephone_number": "276-238-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDSTROM",
        "first_name": "EMIL",
        "middle_name": "WILLIAM",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea Warren Rupe, NP
• Parrisa B Rupe, PA
• RX Plus LLC
• S W Campbell OD PC
• Fawzia Salahuddin, MD, MHS-CL, FACP.
• Karen Sapp, LPN
• Catorra Leigh Schulte
• Senior Home Share, LLC
• Ryan Patrick Shaffner, B.S.
• Michael M Shanks, CRNA

• Clinical Social Worker in Galax, VA
• Providers in Galax, VA by specialty
• Clinical Social Worker in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.