Tina Sanford

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

11442-125 Issued in WI

Practice address

12645 W Burleigh Rd Ste 19
Brookfield, WI 53005-3102

Phone

(262) 432-0670

Fax

(262) 475-0412

NPI assigned

Aug 23, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tina Sanford Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matters of the Spirit LLC

  • Clinic/Center
  • Brookfield, WI
  • NPI 1649661711
  NPD Authorized official

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1578018263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12645 W BURLEIGH RD STE 19",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053102",
            "telephone_number": "262-432-0670",
            "fax_number": "262-475-0412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12645 W BURLEIGH RD STE 19",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053102",
            "telephone_number": "262-432-0670",
            "fax_number": "262-475-0412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "TINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WI",
            "license": "11442-125",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "11442-125",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "SANFORD",
            "credential": "LPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Annabella Salvo
• Katherine Samb, OTA
• Paulina Elizamarie San Fillippo
• Isabel Sanchez
• Victoria Sandstrom, DC
• Sarah McAndrew MD SC
• Diana Sarandos
• Obada S Sarsour I, PHARMACIST
• Erika Sasada
• Nastassia Satahoo, LCSW

• Professional Counselor in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Professional Counselor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.