Sandra Diver, LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

2015026374 Issued in MO

Practice address

301 Sovereign CT
Ballwin, MO 63011-4441

Phone

(636) 200-8171

NPI assigned

Apr 30, 2021

Last updated

Apr 30, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1598348393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15831 BARONS WAY DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630177111",
            "telephone_number": "131-476-6223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SOVEREIGN CT",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114441",
            "telephone_number": "636-200-8171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIVER",
        "first_name": "SANDRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MO",
            "license": "2015026374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandra@marblewellness.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "301 Sovereign Ct",
            "city": "Ballwin",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630114441",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Laura G Denunzio, MD
• Rachel Anne Dickerson, M.D.
• Dierbergs Markets Inc (Dierbergs Lafayette Pharmacy)
• Lisa S Dierdorf, LPC
• Jordan Dietl, OT
• Katherine G Dodge, DPT
• Robbin R Doermer, D.C.
• Carla Mary Doherty, RPH
• Laura Jeep Dougherty, MS CCC SLP
• Mike Downing, CRNA

• Mental Health Counselor in Ballwin, MO
• Providers in Ballwin, MO by specialty
• Mental Health Counselor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.