Active NPI
Dale Marie Sandusky, MA, CCC-SLP
- Speech-Language Pathologist
- Sparta, NC
National Provider Identifier
1679741102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6921
- Practice address
- 179 Combs St
Sparta, NC 28675-8429 - Phone
- (336) 372-2441
- NPI assigned
- Feb 19, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 6921 | NC | Primary |
| Speech-Language Pathologist | 235Z00000X | SA 11953 | FL |
Addresses
Primary practice location
179 Combs St
Sparta, NC 28675-8429
Mailing address
179 Combs St
Sparta, NC 28675-8429
Phone (336) 372-2441
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 |
|---|---|---|---|
| 6921 | NC | MD | Clinical Psychologist |
| SA 11953 | FL | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1203379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357689600000",
"number": "1679741102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "179 COMBS ST",
"city": "SPARTA",
"state": "NC",
"postal_code": "286758429",
"telephone_number": "336-372-2441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "179 COMBS ST",
"city": "SPARTA",
"state": "NC",
"postal_code": "286758429",
"telephone_number": "336-372-2441"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDUSKY",
"first_name": "DALE",
"middle_name": "MARIE",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-02-19",
"last_updated": "2013-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NC",
"license": "6921",
"primary": true
},
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "FL",
"license": "SA 11953",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sparta, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.