Brooke Nicole Sanderson, PSYD

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

PS018190 Issued in PA

Practice address

95 Enterprise St Ste 104
Elizabeth, PA 15037-2070

Phone

(412) 370-4848

NPI assigned

Sep 10, 2012

Last updated

Oct 23, 2024By the provider in NPPES

Sex

Female

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 PA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Sanderson Psychological, LLC

  • Community/Behavioral Health Agency
  • Elizabeth, PA
  • NPI 1699212431
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1347235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1871842591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 ENTERPRISE ST STE 104",
            "city": "ELIZABETH",
            "state": "PA",
            "postal_code": "150372070",
            "telephone_number": "412-754-1100",
            "fax_number": "412-465-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 ENTERPRISE ST STE 104",
            "city": "ELIZABETH",
            "state": "PA",
            "postal_code": "150372070",
            "telephone_number": "412-370-4848"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Berry Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "PA",
            "postal_code": "153012768",
            "country_code": "US",
            "telephone_number": "412-754-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "BROOKE",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC006524",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "PA",
            "license": "PS018190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audrey M Rozell
• Jillian Ruda, M.ED., LPC, NCC
• Kevin Shawn Ryan, D.D.S.
• Theodore R Sames Jr., OD
• Sanderson Psychological, LLC
• Cassandra Sanderson, MS, LPC, NCC, CCTP
• Therese Saunders, RN
• Carrie Anne Scurfield, PT
• Douglas Skinner
• Catherine Michelle Slafka, LPC

• Counseling Psychologist in Elizabeth, PA
• Providers in Elizabeth, PA by specialty
• Counseling Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.