Provider Demographics
NPI:1497801864
Name:SANDERS, JAMES D (MA, LMFT, RBC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:D
Last Name:SANDERS
Suffix:
Gender:M
Credentials:MA, LMFT, RBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6610 FOUNTAIN COVE CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-8198
Mailing Address - Country:US
Mailing Address - Phone:317-403-1212
Mailing Address - Fax:317-823-9851
Practice Address - Street 1:6610 FOUNTAIN COVE CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-8198
Practice Address - Country:US
Practice Address - Phone:317-403-1212
Practice Address - Fax:317-823-9851
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35000160A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist