Provider Demographics
NPI:1467149740
Name:HOWARD, SANDRA GRACE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:GRACE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 MARY ST
Mailing Address - Street 2:
Mailing Address - City:WAYCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:31503-3823
Mailing Address - Country:US
Mailing Address - Phone:912-449-7100
Mailing Address - Fax:912-449-7060
Practice Address - Street 1:434 BRYAN ST
Practice Address - Street 2:
Practice Address - City:NAHUNTA
Practice Address - State:GA
Practice Address - Zip Code:31553-4964
Practice Address - Country:US
Practice Address - Phone:912-449-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional