Active NPI
Sandra M Augustine, MA
- Marriage & Family Therapist
- Bremerton, WA
National Provider Identifier
1629122825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LH00005152
- Practice address
- 5455 Almira Dr SE
Bremerton, WA 98311-8330 - Phone
- (360) 373-5031
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | LH00005152 | WA | Primary |
Addresses
Primary practice location
5455 Almira Dr SE
Bremerton, WA 98311-8330
Mailing address
5455 Almira Dr SE
Bremerton, WA 98311-8330
Phone (360) 373-5031
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 228303 | Other | WA | MANAGED HEALTH NETWORK |
| 91102010657 | Other | WA | KITSAP PHYSICIANS SERVICE |
| A039 | Other | WA | TRICARE |
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
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00005152 | WA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629122825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AUGUSTINE",
"first_name": "SANDRA",
"middle_name": "M",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "WA",
"license": "LH00005152",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MANAGED HEALTH NETWORK",
"identifier": "228303",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KITSAP PHYSICIANS SERVICE",
"identifier": "91102010657",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "A039",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bremerton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.