Provider Demographics
NPI:1881214922
Name:GLOVER, SANDRA JOY (LPC INTERN)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:JOY
Last Name:GLOVER
Suffix:
Gender:F
Credentials:LPC INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 734
Mailing Address - Street 2:
Mailing Address - City:BROOKSHIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77423-0734
Mailing Address - Country:US
Mailing Address - Phone:281-630-1352
Mailing Address - Fax:
Practice Address - Street 1:1700 POST OAK BLVD STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-3973
Practice Address - Country:US
Practice Address - Phone:832-356-0790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-18
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81156101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty