Provider Demographics
NPI:1760033567
Name:SANDERS, ELISE (LPC)
Entity Type:Individual
Prefix:
First Name:ELISE
Middle Name:
Last Name:SANDERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7923 SANTA FE DR
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66204-3644
Mailing Address - Country:US
Mailing Address - Phone:816-307-2367
Mailing Address - Fax:
Practice Address - Street 1:7923 SANTA FE DR
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66204-3644
Practice Address - Country:US
Practice Address - Phone:816-307-2367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3307101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor