Provider Demographics
NPI:1720428923
Name:LANITA SANDERS, MSW, LCSW, & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:LANITA SANDERS, MSW, LCSW, & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDERS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:773-259-5627
Mailing Address - Street 1:857 BURNHAM DR
Mailing Address - Street 2:APT D
Mailing Address - City:UNIVERSITY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60484-3265
Mailing Address - Country:US
Mailing Address - Phone:773-259-5627
Mailing Address - Fax:888-315-0759
Practice Address - Street 1:575 W EXCHANGE ST
Practice Address - Street 2:SUITE 3
Practice Address - City:CRETE
Practice Address - State:IL
Practice Address - Zip Code:60417-2003
Practice Address - Country:US
Practice Address - Phone:888-315-0534
Practice Address - Fax:888-315-0759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-02
Last Update Date:2016-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0154751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty