Provider Demographics
NPI:1316549959
Name:SANDERS, TWANA (LCPC-I)
Entity Type:Individual
Prefix:
First Name:TWANA
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LCPC-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4429 LAWRENCE ST UNIT 1022
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89081-3253
Mailing Address - Country:US
Mailing Address - Phone:702-351-3456
Mailing Address - Fax:
Practice Address - Street 1:6171 W CHARLESTON BLVD BLDG 10
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89146-1126
Practice Address - Country:US
Practice Address - Phone:725-232-1992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-09
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
NVCI5069101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator