Provider Demographics
NPI:1952633521
Name:SANDAHL, LUANN (LPC)
Entity Type:Individual
Prefix:
First Name:LUANN
Middle Name:
Last Name:SANDAHL
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 1:464 LITTLE BEAR RD
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-2961
Mailing Address - Country:US
Mailing Address - Phone:512-789-9170
Mailing Address - Fax:512-268-6592
Practice Address - Street 1:187 ELMHURST
Practice Address - Street 2:SUITE A
Practice Address - City:KYLE
Practice Address - State:TX
Practice Address - Zip Code:78640-6115
Practice Address - Country:US
Practice Address - Phone:512-789-9170
Practice Address - Fax:512-268-6592
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2010-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19352101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional