Jessica Lorraine Sanders, LCSW, PIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0752-1821C Issued in AL

Practice address

209 W Jessamine Ave
Foley, AL 36535-2010

Phone

(205) 602-7365

NPI assigned

Jun 11, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Clinical Social Worker

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Changing Tides Counseling Service LLCGroup PAC ID 0840640447, 2 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Changing Tides Counseling Service, LLC

  • Clinical Social Worker
  • Foley, AL
  • NPI 1205469061
  Medicare reassignment Care Compare group NPD Authorized official
• Dreama Schofield, Licsw, Pip, LLC

  • Clinical Social Worker
  • Daphne, AL
  • NPI 1811613706
  NPD (past)

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683849600000",
    "number": "1669734174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 CYPRESS LAKE DRIVE",
            "city": "GULF SHORES",
            "state": "AL",
            "postal_code": "365429102",
            "telephone_number": "205-602-7365",
            "fax_number": "251-948-9500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 W JESSAMINE AVE",
            "city": "FOLEY",
            "state": "AL",
            "postal_code": "365352010",
            "telephone_number": "205-602-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "JESSICA",
        "middle_name": "LORRAINE",
        "credential": "LCSW, PIP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-11",
        "last_updated": "2023-05-12",
        "certification_date": "2023-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AL",
            "license": "1821C",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AL",
            "license": "0752-1821C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rush Physical Medicine LLC
• Sacred Heart Health System, Inc.
• Philip Low Salstrom III, MD
• Evan Salter
• Howard Douglas Salter, P.T.
• Kara Danielle Sanders, NP
• Patricia A Sanders, PHARMACIST
• Dawn Renee Sarenana, LICSW
• Sarrell Regional Dental Center for Public Health, Inc.
• Sawrie Oncology Inc

• Clinical Social Worker in Foley, AL
• Providers in Foley, AL by specialty
• Clinical Social Worker in Alabama

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

Verify at the official NPI Registry.