Provider Demographics
NPI:1942871264
Name:SANDERS, DONALD LEE (LCMHC)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:LEE
Last Name:SANDERS
Suffix:
Gender:M
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2517 LARWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-3715
Mailing Address - Country:US
Mailing Address - Phone:919-935-1078
Mailing Address - Fax:
Practice Address - Street 1:2517 LARWOOD DR
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-3715
Practice Address - Country:US
Practice Address - Phone:919-935-1078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY101YM0800X
SC101YP2500X
NC14254101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional