Individual provider Active NPI

Michelle Dion Sanders, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Bismarck, ND
National Provider Identifier
1417562265
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1889 Issued in ND
Practice address
101 E Broadway Ave
Bismarck, ND 58501
Phone
(701) 222-0386
Fax
(701) 255-4891
NPI assigned
Sep 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1889 ND Primary

Addresses

Primary practice location

101 E Broadway Ave
Bismarck, ND 58501

Mailing address

101 E Broadway Ave
Bismarck, ND 58501
Phone (701) 222-0386

Other names 1

  • Michelle Mierwald Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1599609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600214400000",
    "number": "1417562265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-222-0386",
            "fax_number": "701-255-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 E BROADWAY AVE",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58501",
            "telephone_number": "701-222-0386",
            "fax_number": "701-255-4891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "MICHELLE",
        "middle_name": "DION",
        "name_prefix": "Mrs.",
        "credential": "LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "MIERWALD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; 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.