Provider Demographics
NPI:1659754646
Name:LAMSMA, SANDRA ALISON
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ALISON
Last Name:LAMSMA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12416 S HARLEM AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1441
Mailing Address - Country:US
Mailing Address - Phone:708-385-4889
Mailing Address - Fax:708-385-4088
Practice Address - Street 1:12416 S HARLEM AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1441
Practice Address - Country:US
Practice Address - Phone:708-385-4889
Practice Address - Fax:708-385-4088
Is Sole Proprietor?:No
Enumeration Date:2015-07-08
Last Update Date:2015-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490167741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical