Individual provider Active NPI

Sandy Lee Rollins

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1497492078
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
11476-C Issued in NV
Practice address
6879 W Charleston Blvd
Las Vegas, NV 89117-1672
Phone
(702) 559-8965
NPI assigned
May 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9852-M NV
Clinical Social Worker 1041C0700X 11476-C NV Primary

Addresses

Primary practice location

6879 W Charleston Blvd
Las Vegas, NV 89117-1672

Mailing address

6879 W Charleston Blvd
Las Vegas, NV 89117-1672
Phone (702) 308-4807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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

Enrollment IDStateProvider typePAC IDDetails
I20240701000400 NV Practitioner - Clinical Social Worker 8022552108 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mindful Therapy Group PCGroup PAC ID 4981872561, 654 clinicians

Practice addresses (Care Compare)

8215 S Eastern Ave
Suite 109
Las Vegas, NV 89123-2515
Phone (775) 902-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9852-MNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mindful Therapy Group PC Clinical CurrentSince Aug 14, 2024 Accepting new patients
Bergdale & Hall, LLC CurrentSince May 15, 2024 Accepting new patients
Bergdale & Hall, LLC Clinical CurrentSince May 15, 2024 Accepting new patients

Locations

8215 S Eastern Ave
Ste 109
Las Vegas, NV 89123
Phone (775) 902-8300

6885 W Charleston Blvd
Las Vegas, NV 89117
Phone (702) 483-7367

6505 216th St SW
Ste 100
Mountlake Terrace, WA 98043
Phone (425) 678-6463

Organizations & group practices 3

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": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1497492078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6879 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171672",
            "telephone_number": "702-308-4807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6879 W CHARLESTON BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891171672",
            "telephone_number": "702-559-8965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROLLINS",
        "first_name": "SANDY",
        "middle_name": "LEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-16",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "9852-M",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "11476-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.