Provider Demographics
NPI:1497904999
Name:TAYLOR-ANDERSON, SANDRA LEE (LPC,CACII, NCAC,BRI)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:TAYLOR-ANDERSON
Suffix:
Gender:F
Credentials:LPC,CACII, NCAC,BRI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11755 POINTE PL
Mailing Address - Street 2:SUITE C
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4656
Mailing Address - Country:US
Mailing Address - Phone:678-893-8757
Mailing Address - Fax:678-893-8756
Practice Address - Street 1:11755 POINTE PL
Practice Address - Street 2:SUITE C
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4656
Practice Address - Country:US
Practice Address - Phone:678-893-8757
Practice Address - Fax:678-893-8756
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2008-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC #00907101Y00000X
GACACII #1760101YA0400X
GALPC#00907101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional