MEDICARE: SAND DOLLAR CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1043065972
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAND DOLLAR CONSULTING, LLC

Provider Business Mailing Address
First Line	:	7951 STREAM WALK WAY
Second Line	:
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732-4666
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7951 STREAM WALK WAY
Second Line	:
City	:	CHESAPEAKE BEACH
State	:	MD
Zip	:	20732-4666
Country	:	US
Telephone Number	:	443-404-9488
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	TIFFANY MICHELLE SANDS
Credential	:	LCPC
Telephone Number	:	443-404-9488

Provider Enumeration Date	:	04/23/2024
Last Update Date	:	04/23/2024

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