Individual provider Active NPI

Ann Marie Michelle Sands, LCSW, CADC

  • Clinical Social Worker
  • Munster, IN
National Provider Identifier
1467868539
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149016756 Issued in IL
Practice address
9250 Columbia Ave Ste 2E
Munster, IN 46321-3530
Phone
(219) 595-0043
Fax
(219) 237-2894
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 31879 IL
Clinical Social Worker 1041C0700X 149016756 IL Primary

Addresses

Primary practice location

9250 Columbia Ave Ste 2E
Munster, IN 46321-3530

Mailing address

9250 Columbia Ave Ste 2E
Munster, IN 46321
Phone (219) 595-0043

Other practice location 1

2130 Schiller Ave
Wilmette, IL 60091-2326
Phone (815) 557-5736

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160307002025 IL Practitioner - Clinical Social Worker 8325344062
I20170428001146 IN Practitioner - Clinical Social Worker 8325344062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Nwi Clarity ClinicGroup PAC ID 5991082976, 32 clinicians

Practice addresses (Care Compare)

9250 Columbia Ave
Suite 2E
Munster, IN 46321-3530
Phone (219) 595-0043

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
31879ILMDAddiction (Substance Use Disorder) Counselor
149016756ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Nwi Clarity Clinic Clinical CurrentSince Oct 1, 2016 Accepting new patients

Locations

1 E Superior St
Ste 306
Chicago, IL 60611
Phone (312) 754-9404

9250 Columbia Ave
Ste 2E
Munster, IN 46321
Phone (219) 595-0043

Interoperability endpoints

  • Direct secure messaging: ccin.annmarie.sands@138327.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597276800000",
    "number": "1467868539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "46321",
            "telephone_number": "219-595-0043",
            "fax_number": "219-237-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9250 COLUMBIA AVE STE 2E",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213530",
            "telephone_number": "219-595-0043",
            "fax_number": "219-237-2894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2130 Schiller Ave",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600912326",
            "country_code": "US",
            "telephone_number": "815-557-5736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDS",
        "first_name": "ANN MARIE",
        "middle_name": "MICHELLE",
        "credential": "LCSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "31879",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149016756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Munster, IN

Sources for this page

Verify at the official NPI Registry.