Provider Demographics
NPI:1114469541
Name:CASE, SANDRA MICHELLE (LMHC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:MICHELLE
Last Name:CASE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:MICHELLE
Other - Last Name:EVAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1911 SW COOPER WAY
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8960
Mailing Address - Country:US
Mailing Address - Phone:619-829-0796
Mailing Address - Fax:
Practice Address - Street 1:1911 SW COOPER WAY
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-8960
Practice Address - Country:US
Practice Address - Phone:619-829-0796
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61198181101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health