Sanford, Jan M

Sanford, Jan M is an individual health care provider with primary practice located at 309 2Nd Ave Se , Watertown SD 57201-3621. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Sanford, Jan M can be contacted via phone (605) 886-6321.

Contact Information

Primary practice address
309 2Nd Ave Se Watertown SD 57201-3621
Phone: (605) 886-6321
Fax: (605) 886-6306
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LPC-MH 2087 South Dakota
Behavioral Health & Social Service Providers / Professional 101YP2500X LPC-MH 2087 South Dakota
Behavioral Health & Social Service Providers / Social Worker 104100000X LSWA 2146 South Dakota

Profile Details

NPI number 1538211701
LBN Legal business name Sanford, Jan M
Credentials LPC-MH, QMHP, LSWA
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 17th, 2007
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538211701 NPPES
Minnesota MEDICAID 154887500
Minnesota Other 20202
Minnesota Other 4997066
Minnesota Other 9173854
Minnesota Other 11350
Minnesota Other 46045
Minnesota MEDICAID 6575620

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