Carolynne Sandbakken, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

950 9TH Ave
St Paul Park, MN 55071-1436

Phone

(651) 686-0518

NPI assigned

Jul 10, 2023

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 names 1

• Carolynne Hahn Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1688947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688947200000",
    "number": "1558049478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR STE 220",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 9TH AVE",
            "city": "ST PAUL PARK",
            "state": "MN",
            "postal_code": "550711436",
            "telephone_number": "651-686-0518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDBAKKEN",
        "first_name": "CAROLYNNE",
        "credential": "LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-10",
        "last_updated": "2023-07-10",
        "certification_date": "2023-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYNNE",
            "last_name": "HAHN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Addiction (Substance Use Disorder) Counselor in St Paul Park, MN
• Providers in St Paul Park, MN by specialty
• Addiction (Substance Use Disorder) Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.

Verify at the official NPI Registry.