Provider Demographics
NPI:1477151942
Name:SANDHU, MANSUKH (MS, NCC, LCPC)
Entity Type:Individual
Prefix:MRS
First Name:MANSUKH
Middle Name:
Last Name:SANDHU
Suffix:
Gender:F
Credentials:MS, NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1421 SWEETBAY LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5933
Mailing Address - Country:US
Mailing Address - Phone:630-400-7985
Mailing Address - Fax:
Practice Address - Street 1:LIFESTANCE HEALTH
Practice Address - Street 2:55 EAST LOOP RD, STE 301
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60189
Practice Address - Country:US
Practice Address - Phone:630-482-7890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-15
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.015821101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health