Provider Demographics
NPI:1457953036
Name:SANDS COUNSELING LLC
Entity Type:Organization
Organization Name:SANDS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACQUELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:786-683-2682
Mailing Address - Street 1:874 UNION ST APT 1
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-3111
Mailing Address - Country:US
Mailing Address - Phone:786-683-2682
Mailing Address - Fax:
Practice Address - Street 1:1168 LAKEVIEW AVE STE 23
Practice Address - Street 2:
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-4763
Practice Address - Country:US
Practice Address - Phone:786-683-2682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-10
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty