MR. MICHAEL P SANDERSON (NPI# 1104121987) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104121987 |
| Entity Type | Individual |
| Full Name | MR. MICHAEL P SANDERSON |
| Credential | CSAC |
| Practice Address |
548 N Lake Ave Phillips WI 54555-1028 |
| Practice Telephone | 7153396453 |
| Practice Fax Number | 7153396450 |
| Mailing Telephone | 7153396453 |
| Mailing Fax Number | 7153396450 |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
246132 | WI | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053769943 | Michael Quintin Sanderson | Pediatrics | 916 Jackson Ave, Sheridan, WY 82801-2708 | 2016-06-01 |
| 1649573270 | Michael J Sanderson | Physical Therapist | 639 S Walker St Ste E, Bloomington, IN 47403-2124 | 2010-12-21 |
| 1215134663 | Michael J Sanderson | Family Medicine | 2751 W 9000 S, West Jordan, UT 84088-8623 | 2007-06-29 |
| Street Address |
548 N LAKE AVE |
| City | PHILLIPS |
| State | WI |
| Zip Code | 54555-1028 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942473780 | Haven House Community Support Center of Price County | Community/Behavioral Health | 548 N Lake Ave, Phillips, WI 54555 | 2008-04-11 |
| 1477809960 | Kate Strang | Registered Nurse | 548 N Lake Ave, Phillips, WI 54555-1028 | 2012-08-02 |
| 1740564525 | Haven House | Registered Nurse | 548 N Lake Ave, Phillips, WI 54555-1028 | 2011-09-28 |
| 1043473606 | Haven House Community Support Center LLC | Community/Behavioral Health | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-07-03 |
| 1285892414 | Pamela Marie Olson | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| 1609034834 | Michelle J Schmidt | Social Worker | 548 N Lake Ave, Phillips, WI 54555-1028 | 2008-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356971162 | Tully Erwin | Pharmacist | 256 South Lave Avenue, Phillips, WI 54555 | 2020-01-21 |
| 1326494543 | New Horizons North, Inc. | Voluntary or Charitable | 1215 N Airport Rd, Phillips, WI 54555 | 2016-05-06 |
| 1801106265 | Kelly Jean Witt-erickson | Social Worker | 548 North Lake Avenue, Phillips, WI 54555 | 2010-10-19 |
| 1629215314 | Roepke Physical Therapy Limited Partnership | Occupational Therapist | N 9691 Highway 13 N, Phillips, WI 54555 | 2009-01-16 |
| 1598922429 | Counseling & Development Center, Inc | Community/Behavioral Health | 171 Chestnut Street, Phillips, WI 54555 | 2008-05-19 |
| 1518134568 | Central Price Co Ambulance Service, Inc | Ambulance | 104c N Argyle, Phillips, WI 54555 | 2008-05-09 |
| 1235304395 | School District of Phillips | Local Education Agency (LEA) | 365 Highway 100, Phillips, WI 54555 | 2008-04-29 |
| 1295947109 | Northern Sight Vision Clinic, LLC | Optometrist | 104a N. Argyle Ave, Phillips, WI 54555 | 2007-05-04 |
| 1902028541 | County of Price | Public Health or Welfare | 104 S Eyder Avenue, Phillips, WI 54555 | 2007-05-03 |
| 1770703035 | Lori A Severson | Chiropractor | 104-c North Argyle Avenue, Phillips, WI 54555 | 2007-04-27 |
| Find all providers in zip 54555 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801397997 | Anna Jo Childs | Counselor | 148 S Avon Ave, Phillips, WI 54555-1308 | 2018-02-23 |
| 1073005757 | Heather R Romatowski | Counselor | 171 Chestnut St, Phillips, WI 54555-1313 | 2018-05-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891396255 | Cassandra C Coates | Counselor | 134 Main St Apt 117, Racine, WI 53403-4623 | 2020-11-03 |
| 1649879982 | Veronicia S Green | Counselor | 2821 N Vel R Phillips Ave Ste 131, Milwaukee, WI 53212-2370 | 2020-10-19 |
| 1578160974 | Jennifer A Nyman | Counselor | 2408 N 89th St, Wauwatosa, WI 53226-1804 | 2020-10-08 |
| 1558977991 | Guided Solutions Therapy, LLC | Counselor | 126 W Holum St, Deforest, WI 53532-1108 | 2020-09-21 |
| 1396359337 | Sarah Luetzow Marten | Counselor | 6441 Enterprise Ln Ste 101, Madison, WI 53719-1180 | 2020-09-08 |
| 1891313656 | Kayla Lynn Fazzari | Counselor | N168w20964 Main St, Jackson, WI 53037-9634 | 2020-07-08 |
| 1518580182 | Michele Denise Perron | Counselor | 912 Baxter Ave, Superior, WI 54880-1735 | 2020-05-18 |
| 1003438391 | Kimberly Rose Schlomann | Counselor | W227s10580 River Ave, Big Bend, WI 53103-9563 | 2020-05-10 |
| 1477174381 | Sarah Ross | Counselor | 302 West Lake St., Friendship, WI 55934 | 2020-05-01 |
| 1124657721 | Joanne Berthelsen Lcsw LLC | Counselor | 830 Armour Rd Ste 2, Oconomowoc, WI 53066-3959 | 2020-04-06 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.