Provider Demographics
NPI:1790926830
Name:SANDIN, ALLISON ROGERS (LISW)
Entity Type:Individual
Prefix:MRS
First Name:ALLISON
Middle Name:ROGERS
Last Name:SANDIN
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:MISS
Other - First Name:LORI
Other - Middle Name:ALLISON
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LISW
Mailing Address - Street 1:703 SCHAFFER ST.
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412-4524
Mailing Address - Country:US
Mailing Address - Phone:843-762-8342
Mailing Address - Fax:843-762-1553
Practice Address - Street 1:4130 FABER PLACE
Practice Address - Street 2:SUITE 115 SAVE
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405-8501
Practice Address - Country:US
Practice Address - Phone:843-747-5327
Practice Address - Fax:843-747-0698
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC56901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical