Provider Demographics
NPI:1790805075
Name:SANDERS, SUE KEY (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SUE
Middle Name:KEY
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 1:2429 28TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79411-1305
Mailing Address - Country:US
Mailing Address - Phone:806-792-6154
Mailing Address - Fax:806-780-5414
Practice Address - Street 1:2429 28TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79411-1305
Practice Address - Country:US
Practice Address - Phone:806-792-6154
Practice Address - Fax:806-780-5414
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15084101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional