Renee L Sandvik

Primary specialty

Social WorkerTaxonomy code 104100000X

License

11669 Issued in MN

Practice address

6040 Earle Brown Dr
Brooklyn Center, MN 55430-2514

Phone

(651) 313-8080

NPI assigned

Mar 20, 2008

Last updated

Sep 12, 2023By 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 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nystrom & Associates, LTD

  dba Sagent Behavioral Health

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1649441304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1370 MENDOTA HEIGHTS RD",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201281",
            "telephone_number": "651-313-8080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302514",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDVIK",
        "first_name": "RENEE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-03-20",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ND",
            "license": "1571",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "4633",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "11669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samey Inc
• Brianna Sampon
• Abby E Sampson
• Emily Sampson
• Sanctuary Brooklyn Center Operations, LLC (Sanctuary at Brooklyn Center)
• Rosalynna Santillan
• Mary Sauer, PHARM.D.
• Annamarie Savariego
• Brooklyn Ciara Saxton
• Hanna Marie Schaefer, LICSW

• Social Worker in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.