Kenneth Eugene Sandin, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW108992 Issued in CA

Practice address

4736 Royal Ave # 254
Eugene, OR 97402-1755

Phone

(707) 502-2833

NPI assigned

Oct 4, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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.

• Center for Loving-Awareness LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Eugene, OR
  • NPI 1356264238
  NPD (past) Authorized official

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1770058851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4736 ROYAL AVE # 254",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974021755",
            "telephone_number": "707-502-2833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4736 ROYAL AVE # 254",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974021755",
            "telephone_number": "707-502-2833"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDIN",
        "first_name": "KENNETH",
        "middle_name": "EUGENE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-04",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L14016",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LCSW108992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Rose Sanders
• Michelle Kaylee Sanders
• Sandra L Sanders, LCSW
• Laura R Sanderson, MD
• Torry Sanderson
• Daniel Vincent Sandlin
• Basilio Arreola Sandoval, COUNSELOR CADC-I
• Diego Sandoval
• Gabriel James Sandoval
• Hector Raul Sandoval Jr.

• Clinical Social Worker in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.