Provider Demographics
NPI:1578605242
Name:CHAMBERS, SANDRA LINN (LMSW, ACSW, CEAP)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:LINN
Last Name:CHAMBERS
Suffix:
Gender:F
Credentials:LMSW, ACSW, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41655 BORCHART ST
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-3326
Mailing Address - Country:US
Mailing Address - Phone:248-390-5153
Mailing Address - Fax:
Practice Address - Street 1:37799 PROFESSIONAL CENTER DR STE 106
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1123
Practice Address - Country:US
Practice Address - Phone:248-343-4695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010721371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI80-0-89-7809-0OtherBLUE CROSS BLUE SHIELD