Veronica Renee Sanderson, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

39003544A Issued in IN

Practice address

3290 Mallard Cove LN
Fort Wayne, IN 46804-2883

Phone

(260) 200-0159

Fax

(260) 433-7154

NPI assigned

Apr 22, 2020

Last updated

Nov 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Veronica Renee Brocher Former name

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Renovate Counseling Services LLCGroup PAC ID 6103246376, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Renovate Counseling Services LLC

  • Mental Health Counselor
  • Bluffton, IN
  • NPI 1689135279
  Medicare reassignment Care Compare group NPD
• Life Story Counseling LLC

  • Mental Health Counselor
  • Fort Wayne, IN
  • NPI 1063094613
  NPD Authorized official
• Center for Brief Therapy PC

  dba Indiana Center for Cognitive Behavior Therapy

  • Prescribing (Medical) Psychologist
  • Fort Wayne, IN
  • NPI 1285839480
  NPD (past)

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668470400000",
    "number": "1457971285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3290 MALLARD COVE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042883",
            "telephone_number": "260-200-0159",
            "fax_number": "260-433-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3290 MALLARD COVE LN",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468042883",
            "telephone_number": "260-200-0159",
            "fax_number": "260-433-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "VERONICA",
        "middle_name": "RENEE",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-22",
        "last_updated": "2022-11-15",
        "certification_date": "2022-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003544A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300049939",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VERONICA",
            "last_name": "BROCHER",
            "middle_name": "RENEE",
            "credential": "LMHC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brenda J Sanders, MSW, ACSW, LCSW
• Connisha Sanders, COTA
• Ireland Sanders, RBT
• Shannah Sanders
• Logan Sanderson
• David Sandifer
• Rebecca Sands, LMHC
• Jodi Elizabeth Sandvik, PT
• Amit N Sanghvi, MD
• Nicholas Sangiacomo, DPT

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2022; 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.

Verify at the official NPI Registry.