Provider Demographics
NPI:1235319310
Name:DUBOIS, SANDRA ELIZABETH (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:ELIZABETH
Last Name:DUBOIS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:SANDRA
Other - Middle Name:ELIZABETH
Other - Last Name:DICKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:615 N. 2ND ST.
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403
Mailing Address - Country:US
Mailing Address - Phone:253-778-9990
Mailing Address - Fax:253-697-8590
Practice Address - Street 1:418 CARPENTER RD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-7905
Practice Address - Country:US
Practice Address - Phone:360-878-9526
Practice Address - Fax:888-223-8248
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2019-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00050155101Y00000X
WALH60108275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor