Active NPI
Sandra Elena Sneiderman, LCPC-C
- Professional Counselor
- South Portland, ME
National Provider Identifier
1265717516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- XL3843
- Practice address
- 125 John Roberts Rd
12
South Portland, ME 04106-3295 - Phone
- (208) 828-0048
- NPI assigned
- Oct 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | XL3843 | ME | Primary |
Addresses
Primary practice location
125 John Roberts Rd
12
South Portland, ME 04106-3295
Mailing address
25 John Roberts Road Port Resources
South Portland, ME 04106
Phone (208) 828-0048
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SES1139 | Medicaid | ME |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| XL3843 | ME | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318982400000",
"number": "1265717516",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 JOHN ROBERTS ROAD PORT RESOURCES",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04106",
"telephone_number": "208-828-0048"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 JOHN ROBERTS RD",
"address_2": "12",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041063295",
"telephone_number": "208-828-0048"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SNEIDERMAN",
"first_name": "SANDRA",
"middle_name": "ELENA",
"credential": "LCPC-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-10-19",
"last_updated": "2011-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ME",
"license": "XL3843",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SES1139",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.