Provider Demographics
NPI:1033650973
Name:SAND, DEBRA (MSC, NCC, LPCC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:
Last Name:SAND
Suffix:
Gender:F
Credentials:MSC, NCC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 ESTATES DR NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87122-2644
Mailing Address - Country:US
Mailing Address - Phone:505-228-3774
Mailing Address - Fax:
Practice Address - Street 1:8401 ESTATES DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87122-2644
Practice Address - Country:US
Practice Address - Phone:505-228-3774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-11
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0187191101YM0800X
NMCTB-2024-0051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health