Provider Demographics
NPI:1407308067
Name:MICHAELS, SANDRA L (MS NCC LMHC-P)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:MICHAELS
Suffix:
Gender:F
Credentials:MS NCC LMHC-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:975 ELMWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3001
Mailing Address - Country:US
Mailing Address - Phone:585-256-3430
Mailing Address - Fax:585-286-9226
Practice Address - Street 1:975 ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3001
Practice Address - Country:US
Practice Address - Phone:585-256-3430
Practice Address - Fax:585-286-9226
Is Sole Proprietor?:No
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP00904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health