Provider Demographics
NPI:1467643577
Name:WOODS, SANDRA JOYCE (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:JOYCE
Last Name:WOODS
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 1:12623 EAGLE NEST DR
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2447
Mailing Address - Country:US
Mailing Address - Phone:512-426-4072
Mailing Address - Fax:512-295-5403
Practice Address - Street 1:1715 FM 1626
Practice Address - Street 2:SUITE 102
Practice Address - City:MANCHACA
Practice Address - State:TX
Practice Address - Zip Code:78652-3553
Practice Address - Country:US
Practice Address - Phone:512-280-5315
Practice Address - Fax:512-280-5316
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18160101Y00000X, 101YM0800X, 101YP2500X
TX239890163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163W00000XNursing Service ProvidersRegistered Nurse