Individual provider Active NPI

Michael Sanders

  • Counseling Psychologist
  • Dedham, MA
National Provider Identifier
1245066638
Registry record updated Sep 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Practice address
16 Milton St Ste 6
Dedham, MA 02026-2991
Phone
(888) 955-1167
Fax
(888) 245-9392
NPI assigned
Sep 11, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X
Health Service Psychologist 103TH0100X
Counseling Psychologist 103TC1900X Primary

Addresses

Primary practice location

16 Milton St Ste 6
Dedham, MA 02026-2991

Mailing address

16 Milton St Ste 6
Dedham, MA 02026-2991
Phone (888) 955-1167

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

Practice roles

OrganizationSpecialtyStatusNew patients
Essence of Pearls Counseling CurrentSince Sep 15, 2024 Accepting new patients

Locations

16 Milton St
Ste 6
Dedham, MA 02026
Phone (866) 955-1167

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.

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726012800000",
    "number": "1245066638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MILTON ST STE 6",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262991",
            "telephone_number": "888-955-1167",
            "fax_number": "888-245-9392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MILTON ST STE 6",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020262991",
            "telephone_number": "888-955-1167",
            "fax_number": "888-245-9392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2024-09-11",
        "certification_date": "2024-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; 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.