Sandra S Champa LCSW Cap LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW8305 Issued in FL

Legal business name

SANDRA S CHAMPA LCSW CAP LLC

Doing business as

sandra champa lcsw

Practice address

1825 Forest Hill Blvd Ste 105
West Palm Beach, FL 33406-6058

Phone

(561) 929-3792

Fax

(954) 785-5808

NPI assigned

Jul 19, 2014

Organization subpart

No

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

Authorized official

Name

Terri Hirschberg

Title

Medical Biller

Phone

(954) 784-2845

Specialties & licenses 1

Addresses

Other names 1

• sandra champa lcsw Doing business as

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Tax ID family

Sandra Champa LCSW2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sandra S Champa LCSW Cap LLC

  • Clinical Social Worker
  • Greenacres, FL
  • NPI 1750760526
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sandra Champa, LCSW

  • Clinical Social Worker
  • Greenacres, FL
  • NPI 1790165470
  Medicare reassignment

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

{
    "created_epoch": "1405728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615507200000",
    "number": "1356758536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7437 PINE PARK DR S",
            "city": "LAKE WORTH",
            "state": "FL",
            "postal_code": "334678852",
            "telephone_number": "561-929-3792",
            "fax_number": "954-785-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 FOREST HILL BLVD STE 105",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334066058",
            "telephone_number": "561-929-3792",
            "fax_number": "954-785-5808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA S CHAMPA LCSW CAP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-19",
        "last_updated": "2021-03-12",
        "certification_date": "2020-11-18",
        "status": "A",
        "authorized_official_last_name": "HIRSCHBERG",
        "authorized_official_first_name": "TERRI",
        "authorized_official_title_or_position": "MEDICAL BILLER",
        "authorized_official_telephone_number": "954-784-2845"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "sandra champa lcsw",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sylvia Sanderson, ARNP
• Sandra Kaur Sandhu-Restaino, D.O.
• Adrian Sandoval
• Angelica Sandoval
• Sandpiper Labs LLC
• Joni Annette Sands
• Muhammad Shoaib Sangani
• Licette Vanessa Sangiovanni, LMHC
• Harminey Sangster
• Julio Sanguily III, M.D.

• Clinical Social Worker in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.