Provider Demographics
NPI:1184216673
Name:GALVAN, SANDRA E (MA, ALMFT)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:E
Last Name:GALVAN
Suffix:
Gender:F
Credentials:MA, ALMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4335 S SACRAMENTO AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-2559
Mailing Address - Country:US
Mailing Address - Phone:312-244-9019
Mailing Address - Fax:
Practice Address - Street 1:4335 S SACRAMENTO AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-2559
Practice Address - Country:US
Practice Address - Phone:312-244-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-06
Last Update Date:2021-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty