Active NPI
Sarah Sistrunk, LPC, MAC
- Professional Counselor
- Villa Rica, GA
National Provider Identifier
1306454624
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 007897
- Practice address
- 1010 Summer Cypress Dr
Villa Rica, GA 30180-6979 - Phone
- (404) 408-5592
- NPI assigned
- Jul 22, 2020
- Last updated
- Jul 22, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 | 007897 | GA | Primary |
Addresses
Primary practice location
1010 Summer Cypress Dr
Villa Rica, GA 30180-6979
Mailing address
1010 Summer Cypress Dr
Villa Rica, GA 30180-6979
Phone (404) 408-5592
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3372 Peachtree Rd NE
Suite 115
Atlanta, GA 30326-1963
Phone (866) 630-0966
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sondermind Provider Network LLC | Professional | Current | Accepting new patients |
Locations
3348 Peachtree Rd NE
Ste 700
Atlanta, GA 30326
Phone (720) 712-7900
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1306454624",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1010 SUMMER CYPRESS DR",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301806979",
"telephone_number": "404-408-5592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1010 SUMMER CYPRESS DR",
"city": "VILLA RICA",
"state": "GA",
"postal_code": "301806979",
"telephone_number": "404-408-5592"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SISTRUNK",
"first_name": "SARAH",
"credential": "LPC, MAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-22",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "007897",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Villa Rica, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; 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.