Individual provider Active NPI

Sandra A. Dyer, LCSW

  • Clinical Social Worker
  • Dover, DE
National Provider Identifier
1891702304
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
Q1-0000296 Issued in DE
Practice address
1679 S Dupont Hwy
Suite 16
Dover, DE 19901-5101
Phone
(302) 735-7738
Fax
(302) 735-8560
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Q1-0000296 DE
Clinical Social Worker 1041C0700X Q1-0000296 DE Primary

Addresses

Primary practice location

1679 S Dupont Hwy
Suite 16
Dover, DE 19901-5101

Mailing address

600 W Division St
Suite 16
Dover, DE 19904-2702
Phone (302) 735-7738

Other identifiers 1

IdentifierTypeStateIssuer
1000021573MedicaidDE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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

Enrollment IDStateProvider typePAC IDDetails
I20110414000604 DE Practitioner - Clinical Social Worker 2163606278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

600 W Division St
Dover, DE 19904-2702
Phone (302) 735-7738

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
Q1-0000296DEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Port in the Storm LLC CurrentSince Apr 4, 2011 Accepting new patients
Port in the Storm Current Accepting new patients

Locations

600 W Division St
Dover, DE 19904
Phone (302) 735-7738

1679 S DuPont Hwy
Ste 16
Dover, DE 19901
Phone (302) 734-9000

600 W Division St
Ste 16
Dover, DE 19904

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1891702304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W DIVISION ST",
            "address_2": "SUITE 16",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199042702",
            "telephone_number": "302-735-7738",
            "fax_number": "302-735-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1679 S DUPONT HWY",
            "address_2": "SUITE 16",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199015101",
            "telephone_number": "302-735-7738",
            "fax_number": "302-735-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "SANDRA",
        "middle_name": "A.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DE",
            "license": "Q1-0000296",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1000021573",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.