Provider Demographics
NPI:1457031163
Name:KEARNS, SANDRA (BS)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:
Last Name:KEARNS
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:SANDRA
Other - Middle Name:
Other - Last Name:SABIN-MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:902 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:62896-2210
Mailing Address - Country:US
Mailing Address - Phone:618-937-6483
Mailing Address - Fax:618-937-1440
Practice Address - Street 1:2302 STATE ST
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4379
Practice Address - Country:US
Practice Address - Phone:618-303-4973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor