Kelley M Sandoval, RAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

RAC #1340 Issued in LA

Practice address

401 Rainbow Dr Unit 35
Pineville, LA 71360-6979

Phone

(318) 487-5191

NPI assigned

Jan 12, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Department of Health and Hospitals

  • Addiction Medicine (Family Medicine) Physician
  • Pineville, LA
  • NPI 1306800289

  Addiction (Substance Use Disorder)

  NPD (past)
• Louisiana Department of Health, Department of Health and Hospitals

  • Skilled Nursing Facility
  • New Orleans, LA
  • NPI 1730674557
  NPD (past)

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

{
    "created_epoch": "1294790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294790400000",
    "number": "1679878235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAINBOW DR UNIT 35",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713606979",
            "telephone_number": "318-487-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RAINBOW DR UNIT 35",
            "city": "PINEVILLE",
            "state": "LA",
            "postal_code": "713606979",
            "telephone_number": "318-487-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDOVAL",
        "first_name": "KELLEY",
        "middle_name": "M",
        "credential": "RAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-12",
        "last_updated": "2011-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "LA",
            "license": "RAC #1340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karren Russo, MD
• Ryland Dental Association
• Cote L Ryland, D.D.S
• Hillee Salley
• Ja'Nae Sanders, PHARMD
• Barbara I Santiago-Roman, MD
• Victoria Sarkar, RN
• Eric Paul Saucier, RPH
• Keri Savell, COTA
• David Sawyer, PHARMD

• Addiction (Substance Use Disorder) Counselor in Pineville, LA
• Providers in Pineville, LA by specialty
• Addiction (Substance Use Disorder) Counselor in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2011; 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.