Provider Demographics
NPI:1639277189
Name:SANDERS, ELIZABETH M (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:M
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3364 W 26TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-2450
Mailing Address - Country:US
Mailing Address - Phone:814-836-0494
Mailing Address - Fax:814-833-5863
Practice Address - Street 1:3364 W 26TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-2450
Practice Address - Country:US
Practice Address - Phone:814-836-0494
Practice Address - Fax:814-833-5863
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0137501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical