Provider Demographics
NPI:1568883288
Name:TIA SANDERS
Entity Type:Organization
Organization Name:TIA SANDERS
Other - Org Name:HOPECHEST CONSULTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:609-817-4673
Mailing Address - Street 1:PO BOX 652
Mailing Address - Street 2:
Mailing Address - City:RANCOCAS
Mailing Address - State:NJ
Mailing Address - Zip Code:08073-0652
Mailing Address - Country:US
Mailing Address - Phone:609-817-4673
Mailing Address - Fax:
Practice Address - Street 1:525 ROUTE 73 S
Practice Address - Street 2:SUITE 306B
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-9642
Practice Address - Country:US
Practice Address - Phone:609-817-4673
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-23
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054926001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty