Individual provider Active NPI

Sandra Scamardella, MA

  • Clinical Psychologist
  • Bingham Farms, MI
National Provider Identifier
1629730668
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
6362009377 Issued in MI
Practice address
30400 Telegraph Rd Ste 331
Bingham Farms, MI 48025-4573
Phone
(248) 629-0728
NPI assigned
Oct 7, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 6362009377 MI Primary

Addresses

Primary practice location

30400 Telegraph Rd Ste 331
Bingham Farms, MI 48025-4573

Mailing address

30400 Telegraph Rd Ste 331
Bingham Farms, MI 48025-4573
Phone (248) 629-0728

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

LicenseStateTypeSpecialty
6362009377MIMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1633564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1629730668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD STE 331",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254573",
            "telephone_number": "248-629-0728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30400 TELEGRAPH RD STE 331",
            "city": "BINGHAM FARMS",
            "state": "MI",
            "postal_code": "480254573",
            "telephone_number": "248-629-0728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCAMARDELLA",
        "first_name": "SANDRA",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-07",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6362009377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bingham Farms, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.