Individual provider Active NPI

Sandra Kay Wynn, ED.D., LMHC

  • Mental Health Counselor
  • Cape Coral, FL
National Provider Identifier
1972715340
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH#8578 Issued in FL
Practice address
923 Del Prado Blvd
Suite # 205
Cape Coral, FL 33990-3652
Phone
(239) 218-9297
Fax
(239) 242-6389
NPI assigned
May 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH#8578 FL Primary

Addresses

Primary practice location

923 Del Prado Blvd
Suite # 205
Cape Coral, FL 33990-3652

Mailing address

923 Del Prado Blvd
Suite # 205
Cape Coral, FL 33990-3652
Phone (239) 218-9297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH#8578FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1178323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972715340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 DEL PRADO BLVD",
            "address_2": "SUITE # 205",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903652",
            "telephone_number": "239-218-9297",
            "fax_number": "239-242-6389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 DEL PRADO BLVD",
            "address_2": "SUITE # 205",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339903652",
            "telephone_number": "239-218-9297",
            "fax_number": "239-242-6389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYNN",
        "first_name": "SANDRA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "ED.D., LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH#8578",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.