Individual provider Active NPI

Matthew Wayne Sandford, LMHC

  • Mental Health Counselor
  • Winter Park, FL
National Provider Identifier
1740590025
Registry record updated Oct 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH10371 Issued in FL
Practice address
2300 Lee Rd
Winter Park, FL 32789-1750
Phone
(407) 339-7451
Fax
(407) 862-2737
NPI assigned
Oct 20, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH10371 FL Primary

Addresses

Primary practice location

2300 Lee Rd
Winter Park, FL 32789-1750

Mailing address

2300 Lee Rd
Winter Park, FL 32789-1750
Phone (407) 339-7451

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

State licenses

LicenseStateTypeSpecialty
MH10371FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1287532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287532800000",
    "number": "1740590025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891750",
            "telephone_number": "407-339-7451",
            "fax_number": "407-862-2737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 LEE RD",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327891750",
            "telephone_number": "407-339-7451",
            "fax_number": "407-862-2737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDFORD",
        "first_name": "MATTHEW",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-10-20",
        "last_updated": "2010-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH10371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2010; 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.