Provider Demographics
NPI:1558940825
Name:SANDELL, KARI LYNN (LMFT, LPCC)
Entity Type:Individual
Prefix:MS
First Name:KARI
Middle Name:LYNN
Last Name:SANDELL
Suffix:
Gender:F
Credentials:LMFT, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:454 LAS GALLINAS AVENUE
Mailing Address - Street 2:PMB 2048
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94903
Mailing Address - Country:US
Mailing Address - Phone:415-252-4894
Mailing Address - Fax:
Practice Address - Street 1:3348 PARADISE DR
Practice Address - Street 2:
Practice Address - City:TIBURON
Practice Address - State:CA
Practice Address - Zip Code:94920-1213
Practice Address - Country:US
Practice Address - Phone:415-252-4894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122528106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist