Individual provider Active NPI

Sharon Layne Sandifer-Bethea, TEXAS LCDC

  • Addiction (Substance Use Disorder) Counselor
  • College Station, TX
National Provider Identifier
1487834453
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
LCDC2902 Issued in TX
Practice address
1600 University Dr E
College Station, TX 77840-2642
Phone
(979) 691-3397
Fax
(979) 691-3332
NPI assigned
Nov 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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 LCDC2902 TX Primary

Addresses

Primary practice location

1600 University Dr E
College Station, TX 77840-2642

Mailing address

1600 University Dr E
College Station, TX 77840-2642
Phone (979) 691-3397

Other identifiers 1

IdentifierTypeStateIssuer
8664BHOtherTXBCBS

Other names 1

  • Miss Sharon Layne Sandifer 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

State licenses

LicenseStateTypeSpecialty
LCDC2902TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1194393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194393600000",
    "number": "1487834453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402642",
            "telephone_number": "979-691-3397",
            "fax_number": "979-691-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 UNIVERSITY DR E",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402642",
            "telephone_number": "979-691-3397",
            "fax_number": "979-691-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIFER-BETHEA",
        "first_name": "SHARON",
        "middle_name": "LAYNE",
        "name_prefix": "Ms.",
        "credential": "TEXAS LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "LCDC2902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8664BH",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHARON",
            "last_name": "SANDIFER",
            "middle_name": "LAYNE",
            "prefix": "MISS",
            "credential": "TEXAS LCDC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Station, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2007; 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.