SANDRA J. PRINCIPE (NPI# 1740300821) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740300821 |
| Entity Type | Individual |
| Full Name | SANDRA J. PRINCIPE |
| Other Name | SANDRA J. AGOSTINE |
| Credential | SAC, PS |
| Practice Address |
1615 Maple Ln Ashland WI 54806-3610 |
| Mailing Address |
620 Prentice Ave Ashland WI 54806-3343 |
| Practice Telephone | 7156855400 |
| Practice Fax Number | 7156855102 |
| Mailing Telephone | 7156826130 |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2009-09-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
15183-131 | WI | Behavioral Health & Social Service Providers |
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
11556-137 | WI | Behavioral Health & Social Service Providers |
| Street Address |
1615 MAPLE LN |
| City | ASHLAND |
| State | WI |
| Zip Code | 54806-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710973508 | Laura K Fortner | Specialist | 1615 Maple Ln, Suite 1, Ashland, WI 54806-3610 | 2005-09-27 |
| 1679185029 | Jacqueline Marie Grimm | Social Worker | 1615 Maple Ln, Ashland, WI 54806-3689 | 2020-08-18 |
| 1669097358 | Kelsey E Larson | Dietitian, Registered | 1615 Maple Ln, Ashland, WI 54806-3689 | 2020-06-09 |
| 1003440967 | Barbara E Jusula | Registered Nurse | 1615 Maple Ln, Ashland, WI 54806-3626 | 2020-02-28 |
| 1841853611 | Paul Michael Kasper | Physician Assistant | 1615 Maple Ln, Ashland, WI 54806-3626 | 2019-04-17 |
| 1770047235 | Ashley Elizabeth Runge | Dietitian, Registered | 1615 Maple Ln, Ashland, WI 54806-3689 | 2019-01-29 |
| 1093220089 | Thomas William Jorgensen | Nurse Anesthetist, Certified Registered | 1615 Maple Ln, Ashland, WI 54806-3626 | 2017-12-12 |
| 1033664719 | Melissa Jean Malmberg | Nurse Practitioner | 1615 Maple Ln, Ashland, WI 54806-3610 | 2016-08-23 |
| 1922488279 | Jenelle Elza | Registered Nurse | 1615 Maple Ln, Ashland, WI 54806-3610 | 2015-06-02 |
| 1811329006 | David L Mischel | Nurse Practitioner | 1615 Maple Ln, Ashland, WI 54806-3610 | 2013-07-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992236525 | Robin Jurgensen | Counselor | 1619 W Third Street, Ashland, WI 54806 | 2017-03-24 |
| 1922479195 | Alexa M Honstad | Registered Nurse | Memorial Medical Center, Inc, 1615 Maple Lane, Ashland, WI 54806 | 2015-10-14 |
| 1982032728 | Noel Hong | Pharmacist | 1800 Us Highway 2, Ashland, WI 54806 | 2013-10-14 |
| 1588909402 | Kelli Danielle Culver | Registered Nurse | 216 3rd St W Ste 201, Ashland, WI 54806 | 2012-12-04 |
| 1114191756 | Karen Keyes | Occupational Therapist | 1635 Maple Lane, Behavioral Health Services, Ashland, WI 54806 | 2008-04-15 |
| 1174645204 | Michael Allyn Turgeon | Social Worker | 517 Beaser Avenue, Ashland, WI 54806 | 2007-04-06 |
| 1770669269 | Laura Anton Ia Nitsche | Speech-Language Pathologist | 618 Beaser Avenue, Ashland, WI 54806 | 2006-10-27 |
| 1104915222 | Patrick Alan Hickman | Chiropractor | 400 East Lakeshore Drive, Ashland, WI 54806 | 2006-10-12 |
| 1386732113 | Janet Lee Sternat | Physical Therapist | 618 Beaser Ave, Cesa #12, Ashland, WI 54806 | 2006-10-10 |
| 1295743193 | Ashland Dental Clinic Inc | Dentist | 300 9th Ave W, Ashland, WI 54806 | 2006-08-04 |
| Find all providers in zip 54806 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861923484 | Lucie Scheuer | Counselor | 66 Crocker St, Ashland, OR 97520-8786 | 2017-03-24 |
| 1316396724 | Lori Wetzel | Counselor | 3118 Main St, Ashland, PA 17921-9433 | 2016-06-07 |
| 1285097204 | Krystina Carnahan | Counselor | 326 Long St, Ashland, KY 41101-2490 | 2016-03-29 |
| 1669880423 | Michelle Moore | Counselor | 302 E Hersey St Ste 8, Ashland, OR 97520-1200 | 2014-07-24 |
| 1134543226 | Lonnie Clark | Counselor | 695 Mistletoe Rd Ste H, Ashland, OR 97520-9552 | 2014-02-10 |
| 1255752697 | Kolpia Counseling Service | Counselor | 302 E Hersey St Ste 1, Ashland, OR 97520-1200 | 2014-01-03 |
| 1306184999 | Michael Hottman | Counselor | 12390 Starting Gate Way, Ashland, VA 23005-3003 | 2013-01-17 |
| 1821357518 | Charles C Vaughn | Counselor | 1526 St. Rt. 603, Ashland, OH 44805 | 2012-05-15 |
| 1982998803 | Lisa M Goodan | Counselor | 700 Wheatley Rd, Ashland, KY 41101-2348 | 2011-06-08 |
| 1871613943 | Randall P. Spangle | Counselor | 502 Main St W Ste 305, Ashland, WI 54806-1512 | 2007-03-30 |
| Find all providers in ASHLAND | ||||
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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.