Provider Demographics
NPI:1922136241
Name:POUPENEY, SANDRA M (LCSW, LADC)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:M
Last Name:POUPENEY
Suffix:
Gender:F
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 HOLCOMB AVE
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1802
Mailing Address - Country:US
Mailing Address - Phone:775-337-6940
Mailing Address - Fax:775-786-5062
Practice Address - Street 1:506 HOLCOMB AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1802
Practice Address - Country:US
Practice Address - Phone:775-337-6940
Practice Address - Fax:775-786-5062
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV887101YA0400X
NV2163-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical