Provider Demographics
NPI:1215412598
Name:SANDRIDGE, AMY LEONA (LCSW, PHD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LEONA
Last Name:SANDRIDGE
Suffix:
Gender:F
Credentials:LCSW, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2626 CHARLES DR
Mailing Address - Street 2:
Mailing Address - City:CHALMETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70043-3779
Mailing Address - Country:US
Mailing Address - Phone:504-278-4006
Mailing Address - Fax:
Practice Address - Street 1:4404 BURKE DR
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70003-2812
Practice Address - Country:US
Practice Address - Phone:504-259-1898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-02
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No171M00000XOther Service ProvidersCase Manager/Care Coordinator