Provider Demographics
NPI:1831449644
Name:SANDS, JACQUELINE (PSYD, LMHC)
Entity type:Individual
Prefix:DR
First Name:JACQUELINE
Middle Name:
Last Name:SANDS
Suffix:
Gender:F
Credentials:PSYD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 UNION ST
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 1:800 TURNPIKE ST STE 201
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-6156
Practice Address - Country:US
Practice Address - Phone:781-646-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA11564101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor