Individual provider Active NPI

Angela M Sanford, LPCC

  • Professional Counselor
  • Lorain, OH
National Provider Identifier
1952995706
Registry record updated Mar 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
E.0500759-SUPV Issued in OH
Practice address
6140 S Broadway
Lorain, OH 44053-3821
Phone
(440) 233-7232
NPI assigned
Feb 23, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E.0500759-SUPV OH
Professional Counselor 101YP2500X E.0500759-SUPV OH Primary

Addresses

Primary practice location

6140 S Broadway
Lorain, OH 44053-3821

Mailing address

6140 S Broadway
Lorain, OH 44053-3821
Phone (440) 233-7232

Other identifiers 1

IdentifierTypeStateIssuer
0434824MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240103004670 OH Practitioner - Mental Health Counselor 7113378134 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0500759-SUPVOHMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Health, Inc CurrentSince Jan 1, 2024 Accepting new patients
Signature Health Inc CurrentSince Jan 1, 2024 Accepting new patients
Signature Health, Inc. Current Accepting new patients

Locations

21100 Southgate Park Blvd
Maple Heights, OH 44137
Phone (216) 663-6100

7232 Justin Way
Mentor, OH 44060
Phone (440) 488-2855

38882 Mentor Ave
Willoughby, OH 44094

38876 Mentor Ave
Willoughby, OH 44094
Phone (440) 954-3333

Organizations & group practices 4

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": "1614038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741824000000",
    "number": "1952995706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-233-7232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6140 S BROADWAY",
            "city": "LORAIN",
            "state": "OH",
            "postal_code": "440533821",
            "telephone_number": "440-233-7232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANFORD",
        "first_name": "ANGELA",
        "middle_name": "M",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-23",
        "last_updated": "2025-03-13",
        "certification_date": "2025-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.0500759-SUPV",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.0500759-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0434824",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lorain, OH

Sources for this page

Verify at the official NPI Registry.