Provider Demographics
NPI:1811104342
Name:LEDET, SANDRA JANE (LCSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JANE
Last Name:LEDET
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHALICE
Other - Middle Name:
Other - Last Name:LEDET
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:6900 N. PECOS RD
Mailing Address - Street 2:VETERANS ADMINSTRATION
Mailing Address - City:N. LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89086
Mailing Address - Country:US
Mailing Address - Phone:702-204-9113
Mailing Address - Fax:
Practice Address - Street 1:6900 PECOS RD
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-4400
Practice Address - Country:US
Practice Address - Phone:702-204-9113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2016-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL44531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical