Provider Demographics
NPI:1588235154
Name:SANDERS, JANICE MARI (LMSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:MARI
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LMSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 223
Mailing Address - Street 2:
Mailing Address - City:WEST OLIVE
Mailing Address - State:MI
Mailing Address - Zip Code:49460-0223
Mailing Address - Country:US
Mailing Address - Phone:317-443-0995
Mailing Address - Fax:
Practice Address - Street 1:5455 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46268-1536
Practice Address - Country:US
Practice Address - Phone:317-443-0995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-06
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003920A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical