Individual provider Active NPI

Pearl Rhonne Sanderson, PH.D.

  • Marriage & Family Therapist
  • Fort Worth, TX
National Provider Identifier
1578795100
Registry record updated Jan 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
005045-005671 Issued in TX
Practice address
3840 Hulen St
Suite 602
Fort Worth, TX 76107-7277
Phone
(817) 729-3034
Fax
(817) 735-4688
NPI assigned
Aug 15, 2009
Last updated
Jan 7, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 005045-005671 TX Primary
Marriage & Family Therapist 106H00000X MT 681 FL

Addresses

Primary practice location

3840 Hulen St
Suite 602
Fort Worth, TX 76107-7277

Mailing address

4704 Pine Ridge LN
Fort Worth, TX 76123-4638
Phone (817) 729-3034

Other identifiers 2

IdentifierTypeStateIssuer
005045-005671OtherTXBOARD OF MARRIAGE AND FAMILY THERAPY
MT 681OtherFLBOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY, AND MENTAL HEALTH COUN

Other names 1

  • Dr. P. Rhonne Sanderson Professional 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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MT 681FLMDMarriage & Family Therapist
005045-005671TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Andrea Harbaugh LPC PA Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1250294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262822400000",
    "number": "1578795100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4704 PINE RIDGE LN",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761234638",
            "telephone_number": "817-729-3034",
            "fax_number": "817-263-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3840 HULEN ST",
            "address_2": "SUITE 602",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761077277",
            "telephone_number": "817-729-3034",
            "fax_number": "817-735-4688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "PEARL",
        "middle_name": "RHONNE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-15",
        "last_updated": "2010-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "005045-005671",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT 681",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF MARRIAGE AND FAMILY THERAPY",
            "identifier": "005045-005671",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY, AND MENTAL HEALTH COUN",
            "identifier": "MT 681",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "P.",
            "last_name": "SANDERSON",
            "middle_name": "RHONNE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2010; 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.