Individual provider Active NPI

Carly Sandstrom, MHC-LP

  • Mental Health Counselor
  • Massapequa, NY
National Provider Identifier
1609655901
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4160 Merrick Rd Ste 5&7
Massapequa, NY 11758-6000
Phone
(516) 350-8978
NPI assigned
Sep 26, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

4160 Merrick Rd Ste 5&7
Massapequa, NY 11758-6000

Mailing address

33 Ellwood St Apt a
Glen Cove, NY 11542-2430
Phone (845) 239-6521

Other practice location 1

520 Franklin Ave Ste L1
Garden City, NY 11530-5892
Phone (516) 350-8978

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

NPI Registry JSON

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1609655901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 ELLWOOD ST APT A",
            "city": "GLEN COVE",
            "state": "NY",
            "postal_code": "115422430",
            "telephone_number": "845-239-6521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 MERRICK RD STE 5&7",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117586000",
            "telephone_number": "516-350-8978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "520 Franklin Ave Ste L1",
            "address_purpose": "LOCATION",
            "city": "Garden City",
            "state": "NY",
            "postal_code": "115305892",
            "country_code": "US",
            "telephone_number": "516-350-8978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDSTROM",
        "first_name": "CARLY",
        "credential": "MHC-LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Massapequa, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.