Sabrina Ann Sepulveda, CRNP-PMH

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

R159759 Issued in MD

Practice address

41625 Park Ave
Leonardtown, MD 20650-3894

Phone

(301) 494-1009

Fax

(970) 296-5636

NPI assigned

Nov 3, 2011

Last updated

Oct 14, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Harborside Behavioral Health, LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Leonardtown, MD
  • NPI 1972069201
  Authorized official Same address or phone

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

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1912284068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 452",
            "city": "VALLEY LEE",
            "state": "MD",
            "postal_code": "206920452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41625 PARK AVE",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206503894",
            "telephone_number": "301-494-1009",
            "fax_number": "970-296-5636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEPULVEDA",
        "first_name": "SABRINA",
        "middle_name": "ANN",
        "credential": "CRNP-PMH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MD",
            "license": "R159759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Summer Seastrand, CNM
• Gwendolyn Seltzer
• Timothy D Semple, CRNA
• Sense-Ability, LLC
• Sense-Ability, LLC
• Sequence Orthodontics
• Serenity Place, LLC
• Shah & Associates LLC
• Shah Associates MD LLC
• Shah Associates MD LLC

• Psychiatric/Mental Health Nurse Practitioner in Leonardtown, MD
• Providers in Leonardtown, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.