Provider Demographics
NPI:1164183901
Name:SANDOW, AMY R (LMHCA, LICSWA, SUDPT)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:SANDOW
Suffix:
Gender:F
Credentials:LMHCA, LICSWA, SUDPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11414 N ROCKAWAY DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-2744
Mailing Address - Country:US
Mailing Address - Phone:509-939-3661
Mailing Address - Fax:
Practice Address - Street 1:11414 N ROCKAWAY DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-2744
Practice Address - Country:US
Practice Address - Phone:509-939-3661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-04
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WASC611924771041C0700X
WACO61134799101YA0400X
WAMC61151125101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)