Active NPI
Dianna Lynn Sandoval, LPC, LAC
- Counselor
- Brighton, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 3395
- Practice address
- 1401 E Bridge St
Brighton, CO 80601-1950 - Phone
- (303) 359-1352
- Fax
- (303) 835-2534
- NPI assigned
- Mar 19, 2008
- Last updated
- Feb 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 3395 | CO | |
| Counselor | 101Y00000X | 3395 | CO | Primary |
Addresses
Primary practice location
1401 E Bridge St
Brighton, CO 80601-1950
Mailing address
1401 E Bridge St
Brighton, CO 80601-1950
Phone (303) 359-1352
Other practice location 1
2002B W 120th Ave # 1
Northglenn, CO 80234-2421
Phone (303) 280-2011
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3395 | CO | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tandem Wellness Center, LLC | Addiction (Substance Use Disorder) | Current | Accepting new patients |
Locations
1401 E Bridge St
Brighton, CO 80601
Phone (303) 359-1352
2002 W 120th Ave
Ste B
Northglenn, CO 80234
Phone (303) 280-2011
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Professional Counselor
- Brighton, CO
- NPI 1588081251
Addiction (Substance Use Disorder)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1205884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1760653554",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1401 E BRIDGE ST",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806011950",
"telephone_number": "303-359-1352",
"fax_number": "303-835-2534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 E BRIDGE ST",
"city": "BRIGHTON",
"state": "CO",
"postal_code": "806011950",
"telephone_number": "303-359-1352",
"fax_number": "303-835-2534"
}
],
"practiceLocations": [
{
"address_1": "2002B W 120th Ave # 1",
"address_purpose": "LOCATION",
"city": "Northglenn",
"state": "CO",
"postal_code": "802342421",
"country_code": "US",
"telephone_number": "303-280-2011",
"fax_number": "303-920-1296",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SANDOVAL",
"first_name": "DIANNA",
"middle_name": "LYNN",
"credential": "LPC, LAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-19",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CO",
"license": "3395",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CO",
"license": "3395",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brighton, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.