Mark Alan Sanford-Pelcher

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6301007605 Issued in MI

Practice address

1000 Monroe Ave NW
Grand Rapids, MI 49503-1455

Phone

(616) 259-7207

Fax

(616) 259-7261

NPI assigned

Mar 23, 2007

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1174608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1790802833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 BUTH DR NE",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219698",
            "telephone_number": "616-581-1214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MONROE AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031455",
            "telephone_number": "616-259-7207",
            "fax_number": "616-259-7261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Cherry St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034526",
            "country_code": "US",
            "telephone_number": "616-965-8200 x7159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANFORD-PELCHER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-23",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401007748",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301007605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick S. Sandro, PT
• Madalyn Sandtveit, OTR/L
• Dominic J Sanfilippo II, MD
• Sanford Psych Services LLC
• Sanford West LLC
• Jon Alexander Sanford, DO
• Kali Marie Sanford, DO
• Kayla Brianna Sanford
• Lucas Mark Sanford, CSFA
• Molly Sanford, LLMSW

• Counseling Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.