Individual provider Active NPI

Sandra Italiano, MA, LPC

  • Counselor
  • Miami Lakes, FL
National Provider Identifier
1972052314
Registry record updated Jan 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
2015016672 Issued in MO
Practice address
8302 Commerce Way Apt 217
Miami Lakes, FL 33016-1604
Phone
(202) 285-3881
NPI assigned
Sep 27, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 2015016672 MO Primary

Addresses

Primary practice location

8302 Commerce Way Apt 217
Miami Lakes, FL 33016-1604

Mailing address

8302 Commerce Way Apt 217
Miami Lakes, FL 33016-1604
Phone (202) 285-3881

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, MO, SC3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240409002842 FL Practitioner - Mental Health Counselor 1951749050 Reassigns benefits to 1 organization
I20241030004389 MO Practitioner - Mental Health Counselor 1951749050 Reassigns benefits to 1 organization
I20250925002215 SC Practitioner - Mental Health Counselor 1951749050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
2015016672MOMDCounselor
11311SCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA CurrentSince Mar 5, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

4625 Lindell Blvd
Ste 200
Saint Louis, MO 63108
Phone (314) 833-8765

170 Meeting St
Ste 110
Charleston, SC 29401
Phone (704) 610-1304

Organizations & group practices 1

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": "1474934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706313600000",
    "number": "1972052314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8302 COMMERCE WAY APT 217",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161604",
            "telephone_number": "202-285-3881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8302 COMMERCE WAY APT 217",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330161604",
            "telephone_number": "202-285-3881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITALIANO",
        "first_name": "SANDRA",
        "credential": "MA, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-27",
        "last_updated": "2024-01-27",
        "certification_date": "2024-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MO",
            "license": "2015016672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami Lakes, FL

Sources for this page

Verify at the official NPI Registry.