Active NPI
Blake Sanford
- Professional Counselor
- Charleston, SC
National Provider Identifier
1497435218
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 8502
- Practice address
- 1 Carriage LN, Building B, Suite 102
Charleston, SC 29407 - Phone
- (843) 619-7928
- NPI assigned
- Jul 18, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 8502 | SC | Primary |
Addresses
Primary practice location
1 Carriage LN, Building B, Suite 102
Charleston, SC 29407
Mailing address
40 Captiva Row Unit B
Charleston, SC 29407-9650
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
| License | State | Type | Specialty |
|---|---|---|---|
| 8502 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689638400000",
"number": "1497435218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CAPTIVA ROW UNIT B",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "294079650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 CARRIAGE LN, BUILDING B, SUITE 102",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29407",
"telephone_number": "843-619-7928"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANFORD",
"first_name": "BLAKE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-07-18",
"last_updated": "2023-07-18",
"certification_date": "2023-07-18",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "SC",
"license": "8502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.