Active NPI
Sandra M. Dannenbaum, PHD
- Counseling Psychologist
- Tempe, AZ
National Provider Identifier
1669483954
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 3828
- Practice address
- 7650 S McClintock Dr
Suite 103-174
Tempe, AZ 85284-1695 - Phone
- (480) 452-4797
- Fax
- (480) 718-7859
- NPI assigned
- Aug 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 3828 | AZ | Primary |
Addresses
Primary practice location
7650 S McClintock Dr
Suite 103-174
Tempe, AZ 85284-1695
Mailing address
7650 S McClintock Dr
Suite 103-174
Tempe, AZ 85284-1695
Phone (480) 452-4797
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128424 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
7650 S McClintock Dr
Suite 103 174
Tempe, AZ 85284-1695
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3828 | AZ | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1669483954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7650 S MCCLINTOCK DR",
"address_2": "SUITE 103-174",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841695",
"telephone_number": "480-452-4797",
"fax_number": "480-264-2763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7650 S MCCLINTOCK DR",
"address_2": "SUITE 103-174",
"city": "TEMPE",
"state": "AZ",
"postal_code": "852841695",
"telephone_number": "480-452-4797",
"fax_number": "480-718-7859"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DANNENBAUM",
"first_name": "SANDRA",
"middle_name": "M.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-11",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "AZ",
"license": "3828",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "128424",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tempe, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.