Active NPI
Judith L Sanders, QMHP
- Mental Health Counselor
- North Bend, OR
National Provider Identifier
1992916985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- C 1617
- Practice address
- 1975 McPherson St
Suite 2
North Bend, OR 97459-3482 - Phone
- (541) 756-2020
- Fax
- (541) 756-8982
- NPI assigned
- May 24, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C 1617 | OR | Primary |
| Mental Health Counselor | 101YM0800X | 10925 | AZ |
Addresses
Primary practice location
1975 McPherson St
Suite 2
North Bend, OR 97459-3482
Mailing address
1975 McPherson St
Suite 2
North Bend, OR 97459-3482
Phone (541) 756-2020
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
| License | State | Type | Specialty |
|---|---|---|---|
| C 1617 | OR | MD | Mental Health Counselor |
| 10925 | AZ | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992916985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1975 MCPHERSON ST",
"address_2": "SUITE 2",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974593482",
"telephone_number": "541-756-2020",
"fax_number": "541-756-8982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1975 MCPHERSON ST",
"address_2": "SUITE 2",
"city": "NORTH BEND",
"state": "OR",
"postal_code": "974593482",
"telephone_number": "541-756-2020",
"fax_number": "541-756-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDERS",
"first_name": "JUDITH",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "QMHP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C 1617",
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "10925",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Bend, OR
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.