NPIMap

Organization Active NPI

Sandalwood Mental Health, PLLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Lake Wylie, SC
National Provider Identifier
1710662341
Registry record updated Jun 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SANDALWOOD MENTAL HEALTH, PLLC
Practice address
244 Latitude LN Ste 104
Lake Wylie, SC 29710-8125
Phone
(803) 809-3184
Fax
(803) 615-4662
NPI assigned
Jun 20, 2023
Last updated
Jun 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2026

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

Authorized official

Name
Peter A. Bertelli, APRNNPI 1235766338
Title
Ceo
Phone
(508) 538-3165

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X Primary

Addresses

Primary practice location

244 Latitude LN Ste 104
Lake Wylie, SC 29710-8125

Mailing address

PO Box 1081
Clover, SC 29710-4081
Phone (803) 809-3184

Other practice location 1

105 Webster St Ste 5
Hanover, MA 02339-1227
Phone (508) 538-3165

Other practice location 2

917 SW Oak St Ste 417
Portland, OR 97205-2807
Phone (503) 743-0512

Other practice location 3

8440 Rea Rd Ste M
Charlotte, NC 28277-4230
Phone (803) 809-3184

Other practice location 4

1030 N Center Pkwy Ste 112
Kennewick, WA 99336-7160
Phone (803) 809-3184

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NC, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20240605002666 MA Part B Supplier - Clinic/Group Practice 0648712638 Receives reassigned benefits from 2 practitioners
Practice locations: Hanover, MA
O20240806001512 NC Part B Supplier - Clinic/Group Practice 0648712638 Receives reassigned benefits from 1 practitioner
Practice locations: Charlotte, NC
O20240823002212 SC Part B Supplier - Clinic/Group Practice 0648712638 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Wylie, SC

National Provider Directory

National Provider Directory
Tax ID family
Sandalwood Mental Health PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

55 County Rd
#2
Mattapoisett, MA 02739

55 County Rd
Ste 2
Mattapoisett, MA 02739
Phone (508) 264-0144

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1687219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781913600000",
    "number": "1710662341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1081",
            "city": "CLOVER",
            "state": "SC",
            "postal_code": "297104081",
            "telephone_number": "803-809-3184",
            "fax_number": "803-615-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 LATITUDE LN STE 104",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297108125",
            "telephone_number": "803-809-3184",
            "fax_number": "803-615-4662"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Webster St Ste 5",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "MA",
            "postal_code": "023391227",
            "country_code": "US",
            "telephone_number": "508-538-3165",
            "fax_number": "508-571-0210",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "917 SW Oak St Ste 417",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972052807",
            "country_code": "US",
            "telephone_number": "503-743-0512",
            "fax_number": "803-615-4662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8440 Rea Rd Ste M",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282774230",
            "country_code": "US",
            "telephone_number": "803-809-3184",
            "fax_number": "803-615-4662",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1030 N Center Pkwy Ste 112",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "993367160",
            "country_code": "US",
            "telephone_number": "803-809-3184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDALWOOD MENTAL HEALTH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-20",
        "last_updated": "2026-06-20",
        "certification_date": "2026-06-20",
        "status": "A",
        "authorized_official_last_name": "BERTELLI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "508-538-3165",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Wylie, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.