MS. SANDRA LEE MATTSON EBELTOFT (NPI# 1558589234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558589234 |
| Entity Type | Individual |
| Full Name | MS. SANDRA LEE MATTSON EBELTOFT |
| Credential | ED.S. |
| Practice Address |
12606 E. Main St. Mayer AZ 86333 |
| Mailing Address |
1950 Lazy Meadow Ln Prescott AZ 86303-5044 |
| Practice Telephone | 9286421010 |
| Practice Fax Number | 9286324005 |
| Mailing Telephone | 9284450121 |
| Mailing Fax Number | 9285419043 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
12606 E. MAIN ST. |
| City | MAYER |
| State | AZ |
| Zip Code | 86333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548471972 | Mayer Unified School District #43 | Local Education Agency (LEA) | 12606 E. Main St., Mayer, AZ 86333-1059 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003382458 | Best Care Behavioral Homes LLC | Community/Behavioral Health | 13190 Central Ave, Mayer, AZ 86333 | 2018-10-23 |
| 1699091710 | Spring Ridge Academy | Psychiatric Residential Treatment Facility | 13690 S. Burton Rd., Spring Valley, AZ 86333 | 2010-04-14 |
| 1083930283 | Zena Anne Kimbrell | Day Training/Habilitation Specialist | 13522 Main Street, Mayer, AZ 86333 | 2010-04-13 |
| 1720225279 | Jim Nester Loukola | Specialist | 20216 E. Conestogao Dr., Mayer, AZ 86333 | 2009-01-20 |
| 1629297072 | Regina Shawn Kenyon Carlson | Occupational Therapy Assistant | 15452 Cholla Cir, Mayer, AZ 86333 | 2007-04-24 |
| 1083774558 | Kim Machelle Remington | Specialist | 13251 Main Street, Mayer, AZ 86333 | 2006-12-12 |
| 1164582250 | Antoinette Josephine Leggitt | Specialist | 17441 Trail End Road, Mayer, AZ 86333 | 2006-12-11 |
| 1588081087 | Joshua E Motl | Physician Assistant | 20172 E Stagecoach Trl, Cordes Lakes, AZ 86333 | 2014-03-21 |
| 1558617506 | Emily Catherine Norman | Nurse Practitioner | 17301 E Spring Valley Rd Ste F, Spring Valley, AZ 86333 | 2012-07-27 |
| 1407164767 | Kimberly Ann Whitehill | Nurse Practitioner | 17301 E Spring Valley Rd Ste F, Spring Valley, AZ 86333 | 2010-09-21 |
| Find all providers in zip 86333 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053912691 | Jane Ann Petschow | Psychologist | 445 W Chandler Blvd Apt 464, Chandler, AZ 85225-1965 | 2020-11-02 |
| 1225635154 | Shannon Napelee | Psychologist | 9405 N 53rd Dr, Glendale, AZ 85302-3305 | 2020-10-04 |
| 1922616929 | Latisha Kareem Ojuriye | Psychologist | 400 N Coronado St Apt 1012, Chandler, AZ 85224-4184 | 2020-07-16 |
| 1689299133 | Chloe Arns | Psychologist | 16484 N 68th Ave, Peoria, AZ 85382-3981 | 2020-06-10 |
| 1710522487 | Aubri Hall | Psychologist | 21115 E Alyssa Rd, Queen Creek, AZ 85142-6556 | 2019-11-16 |
| 1659927242 | Kristin Lee Carbone-kebble | Psychologist | 480 Mate Ln, Lake Havasu City, AZ 86406-6201 | 2019-08-10 |
| 1841843067 | Rebecca Harmon | Psychologist | 6151 E Wildcat Dr, Cave Creek, AZ 85331-3043 | 2019-07-17 |
| 1922589126 | Lisa M Browne | Psychologist | 3584 E Fox Trotter Rd, Tucson, AZ 85739-8334 | 2018-08-24 |
| 1336637321 | Rebecca Simonson | Psychologist | 6200 E San Bernardino, Tucson, AZ 85715-3037 | 2018-04-25 |
| 1053826545 | Angela Coyle | Psychologist | 4841 W Lone Dove Dr, Marana, AZ 85658-4735 | 2017-12-06 |
| 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.