Individual provider Active NPI

Joshua Aaron Sandaker

  • Mental Health Counselor
  • Longview, WA
National Provider Identifier
1346916665
Registry record updated Sep 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LH61507725 Issued in WA
Practice address
720 14TH Ave
Longview, WA 98632-2315
Phone
(360) 423-0203
Fax
(360) 577-0187
NPI assigned
Aug 17, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LH61507725 WA Primary

Addresses

Primary practice location

720 14TH Ave
Longview, WA 98632-2315

Mailing address

PO Box 1847
Longview, WA 98632-8140
Phone (360) 423-0203

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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

Enrollment IDStateProvider typePAC IDDetails
I20240226003098 WA Practitioner - Mental Health Counselor 9931544301 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians
Columbia WellnessGroup PAC ID 2567358286, 9 clinicians

Practice addresses (Care Compare)

Shelton, WA 98584
Phone (323) 205-7088

720 14TH Ave
Longview, WA 98632-2315
Phone (360) 423-0396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LH61507725WAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Columbia Wellness CurrentSince Feb 10, 2024 Accepting new patients

Locations

720 14th Ave
Longview, WA 98632

921 14th Ave
Longview, WA 98632

Organizations & group practices 2

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": "1629158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756857600000",
    "number": "1346916665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328140",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDAKER",
        "first_name": "JOSHUA",
        "middle_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-17",
        "last_updated": "2025-09-03",
        "certification_date": "2025-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH61507725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

Verify at the official NPI Registry.