Provider Demographics
NPI:1811188204
Name:SANDEL, SANDRA DALTON (LPC)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:DALTON
Last Name:SANDEL
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 1:2450 ATLANTA HWY
Mailing Address - Street 2:SUITE 801
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-8099
Mailing Address - Country:US
Mailing Address - Phone:678-455-0083
Mailing Address - Fax:678-455-0085
Practice Address - Street 1:2450 ATLANTA HWY
Practice Address - Street 2:SUITE 801
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8099
Practice Address - Country:US
Practice Address - Phone:678-455-0083
Practice Address - Fax:678-455-0085
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003381101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional