Sandra Bruno
Individual provider Active NPI Marriage & Family Therapist · Madison, AL
NPI 1811522253 · NPPES record last updated Mar 5, 2020
Key facts
- NPI
- 1811522253
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- L450 (AL)
- Practice address
- 102 Wesly Clark Blvd
Madison, AL 35756-4028 - Phone
- (256) 658-6642
- NPI assigned
- Mar 5, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Still Waters Counseling and Education Center
Practice addresses (Care Compare)
400 Office Park Dr
Suite 230
Mountain BRK, AL 35223-3410
Phone (205) 825-1423
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240306001000 | AL | Practitioner - Marriage and Family Therapist | 9638515265 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AADC169 | AL | MD | Addiction (Substance Use Disorder) Counselor |
| L450 | AL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Still Waters Counseling and Education Center | Current |
Accepting new patients | |
| Still Waters Counseling Center, LLC | Current |
Accepting new patients |
Locations
1594 Old Railroad Bed Rd
Harvest, AL 35749
Phone (205) 825-1423
400 Office Park Dr
Ste 230
Mountain Brk, AL 35223
Phone (205) 825-1423
217 Country Club Park
Mountain Brk, AL 35213
Phone (205) 276-1895
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | AADC169 | AL | |
| Marriage & Family Therapist | 106H00000X | L450 | AL | Yes |
Addresses
Primary practice location
102 Wesly Clark Blvd
Madison, AL 35756-4028
Mailing address
102 Wesly Clark Blvd
Madison, AL 35756-4028
Other providers in Madison, AL
- Tammie Sherrie Brown
- Denise Browne
- Russell Leslie Browning
- Mary Alice Broyles
- David Bruce
- Elizabeth Maguire Bryant
- Marian A Bryant
- Mary Bryant
- Nicole Katlyn Buccieri
- Herbert Nolan Buckner
All providers in Madison, AL · Marriage & Family Therapist in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.