Active NPI
Jeffrey Sanders, LPCC
- Professional Counselor
- Warren, OH
National Provider Identifier
1609280437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- E0008367
- Practice address
- 820 Pine Ave SE
Warren, OH 44483-6524 - Phone
- (330) 393-0598
- Fax
- (330) 393-0700
- NPI assigned
- Jun 19, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | E0008367 | OH | Primary |
Addresses
Primary practice location
820 Pine Ave SE
Warren, OH 44483-6524
Mailing address
820 Pine Ave SE
Warren, OH 44483-6524
Phone (330) 393-0598
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0803312 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0008367 | OH | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1403136000000",
"number": "1609280437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 PINE AVE SE",
"city": "WARREN",
"state": "OH",
"postal_code": "444836524",
"telephone_number": "330-393-0598",
"fax_number": "330-393-0700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 PINE AVE SE",
"city": "WARREN",
"state": "OH",
"postal_code": "444836524",
"telephone_number": "330-393-0598",
"fax_number": "330-393-0700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "JEFFREY",
"credential": "LPCC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-19",
"last_updated": "2014-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "OH",
"license": "E0008367",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0803312",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Warren, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.