Provider Demographics
NPI:1871218446
Name:SANDPIPER COUNSELING LLC
Entity type:Organization
Organization Name:SANDPIPER COUNSELING LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MALGORZATA
Authorized Official - Middle Name:
Authorized Official - Last Name:NUSSBAUM
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LCMFT, LMFT, LAC
Authorized Official - Phone:719-210-1420
Mailing Address - Street 1:PO BOX 26
Mailing Address - Street 2:
Mailing Address - City:AIRVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17302-0026
Mailing Address - Country:US
Mailing Address - Phone:719-210-1420
Mailing Address - Fax:
Practice Address - Street 1:2206 OLD EMMORTON RD STE 100-309
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-6172
Practice Address - Country:US
Practice Address - Phone:410-405-7515
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-06
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1346789500Medicaid