Provider Demographics
NPI:1295842227
Name:EPPERSON, SANDRA ELLEN (MA, LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELLEN
Last Name:EPPERSON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 N OAK TRFY
Mailing Address - Street 2:SUITE H
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-2611
Mailing Address - Country:US
Mailing Address - Phone:816-454-5525
Mailing Address - Fax:816-453-5981
Practice Address - Street 1:3805 N OAK TRFY
Practice Address - Street 2:SUITE H
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-2611
Practice Address - Country:US
Practice Address - Phone:816-454-5525
Practice Address - Fax:816-453-5981
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOCS001985101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health