Provider Demographics
NPI:1376044396
Name:SANDERS, JAMES (LPC, CRAADC, NCC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SANDERS
Suffix:
Gender:M
Credentials:LPC, CRAADC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 WASHINGTON AVE UNIT 610
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63103-1653
Mailing Address - Country:US
Mailing Address - Phone:314-309-7715
Mailing Address - Fax:
Practice Address - Street 1:2020 WASHINGTON AVE UNIT 610
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63103-1653
Practice Address - Country:US
Practice Address - Phone:314-309-7715
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-25
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014034467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional